SICOT J. 2025;11:E2. doi: 10.1051/sicotj/2025053. Epub 2025 Sep 24.

ABSTRACT

Physicians often grapple with the delicate balance between providing full disclosure and shielding patients from harsh realities. Honesty, empathy, and patient-centered care are crucial elements influencing patient outcomes and well-being. The revelation process of life-threatening diseases triggers distinct psychological coping stages, emphasizing the need for sensitive communication. Cultural factors further shape communication dynamics, necessitating individualized approaches. As such, this paper discusses the need for truth in the relationships and interactions of doctors and patients, emphasizes adequate information of patients based on honesty and consideration of their expectations, environment, and cultural values, and explores the pivotal role of bioethics education and training in preparing medical professionals to navigate these complex situations. By integrating bioethics education into medical curricula, fostering open and honest communication, and building strong patient-doctor relationships, we can enhance the quality of care and empower patients to embrace their medical journey with dignity and acceptance.

PMID:40990379 | PMC:PMC12459106 | DOI:10.1051/sicotj/2025053

Injury. 2025 Sep 11;56(11):112759. doi: 10.1016/j.injury.2025.112759. Online ahead of print.

ABSTRACT

PURPOSE: The disability and pain after a neglected scaphoid non-union fracture are well recorded in the literature. We aimed to compare and detect the short-term results of non-united scaphoid waist fracture treated by internal fixation and bone graft with the volar buttress plate utilization versus the Herbert screw.

METHODS: This is a therapeutic study. This randomized, prospective comparative an intervention study was carried out on 30 cases with non-union scaphoid waist fractures. They were randomly categorized into two equal groups, group (A) treated by volar buttress plate fixation with bone graft, and group (B) managed by Herbert screw fixation along with bone graft. Bone graft in both groups was taken from the distal radius. All cases underwent clinical examination and radiological evaluation.

RESULTS: With an average of 18 months, thirty cases were followed up. Both groups had similar baseline characteristics. The union rate and time were insignificant difference between both groups. Insignificant differences were determined across either intervention groups in terms of grip strength, the visual analogue pain scale (VAS), the Mayo wrist score, and the quick disabilities of arm, shoulder and hand score (quick DASH score) during the early interval of follow-up postoperatively (at 3, 6, 9 and 12 months). Group (A) demonstrated shorter operative time and lower numbers of image intensifier intraoperatively in contrast to group (B). Hardware removal after union was needed in 3 patients of group (A) in variance to group (B), in which no cases need implant removal. The Radio-scaphoid (RS) impingement and flexor carpi radialis (FCR) tenosynovitis exhibited a significant elevation in group (A) in contrast to group (B). Among the patients with scaphoid fracture non-union who underwent surgery, some cases did not achieve union after the initial procedure. We had to employ an alternative fixation method for these cases, and we followed them until union was achieved, and their function was restored. Specifically, three patients from group (A) (20%) [one case was fixed with a miniplate 2 mm, and two cases were fixed with a microplate 1.5 mm] and two patients from group (B) (13.3 %) required this approach.

CONCLUSIONS: The functional and radiological outcomes are comparable between volar buttress plate and Herbert screw in the treatment of non-united waist scaphoid fracture. The rate of removal of the implant is higher in the volar buttress plate.

PMID:40987252 | DOI:10.1016/j.injury.2025.112759

Int Orthop. 2025 Sep 23. doi: 10.1007/s00264-025-06660-8. Online ahead of print.

ABSTRACT

PURPOSE: Three-dimensional robotic planning may oblige the surgeon to accept an anterior overhang of the acetabular cup. Whether this planned overhang compromises short-term outcomes is unknown.

METHODS: We retrospectively reviewed 437 consecutive robotic total hip arthroplasties (THA) performed between November 2018 and March 2022; 192 hips with complete 3-D screenshots and 12-month follow-up formed the study cohort. Anterior overhang on the definitive plan was graded minor (≤ 2 mm), moderate (between 2 and 4 mm), or major (≥ 4 mm). Primary outcome was psoas pain at one year, defined by pain on resisted-hip-flexion testing; psoas impingement was confirmed if infiltration or tenotomy was performed. Secondary endpoints were Harris Hip Score (HHS), Oxford Hip Score (OHS) and Forgotten Joint Score (FJS-12).

RESULTS: Planned overhang occurred in 52 of 192 hips (27%): 33 minor, 18 moderate and one major. Psoas pain was more frequent with overhang (16% vs. 3.8%; p = 0.008); no differences were recorded for confirmed psoas impingement, groin pain, re-operation or revision of implants. Differences of mean HHS, OHS and FJS-12 at three and twelve months were non-significant between groups. Anterior wall index < 0.33, lateral center-edge angle < 25° and female sex are associated with overhang.

CONCLUSIONS: Minor anterior cup overhang is common in robotic THA. It increases the likelihood of clinical psoas impingement but does not impair early hip function or raise revision risk. Accepting minor overhang is clinically acceptable when necessary, provided patients are counselled about increased psoas pain risk and high-risk anatomies are monitored.

PMID:40986041 | DOI:10.1007/s00264-025-06660-8

Int Orthop. 2025 Sep 23. doi: 10.1007/s00264-025-06657-3. Online ahead of print.

ABSTRACT

PURPOSE: To evaluate the effectiveness and safety of anterior scoliosis correction (ASC) in patients over 40 years of age.

METHODS: This prospective study included 29 patients (mean age 46.6 ± 8.8 years) with idiopathic or adult spinal deformity and a Cobb angle > 30°, who underwent ASC. The follow-up two to five years. Outcomes assessed were Cobb angle correction, quality of life (ODI, SRS-22, SF-36), and postoperative complications.

RESULTS: The mean Cobb angle correction was 59% (from 52.5° to 21.3°). At final follow-up (2.8 ± 1.1), a slight increase to 24.0° was observed, mainly due to curve subsidence. No complications occurred in 62% of patients. Subsidence > 5° was noted in 17% (n = 5), and loss of correction > 15° in 3% (n = 1). One patient experienced persistent pain managed conservatively. Higher risk of subsidence was associated with age > 50 years and preoperative Cobb angle > 50°. Quality of life improved across all measures: ODI decreased from 45% to 32%, SF-36 increased from 50 to 65, and SRS-22 declined slightly from 3.9 to 3.7 in patients with tether settling.

CONCLUSION: ASC demonstrates high effectiveness and acceptable safety for scoliosis correction in patients over 40 years. Subsidence is the primary adverse event, warranting further investigation and careful patient selection.

PMID:40986040 | DOI:10.1007/s00264-025-06657-3

Int Orthop. 2025 Sep 23. doi: 10.1007/s00264-025-06659-1. Online ahead of print.

ABSTRACT

INTRODUCTION: In medial opening wedge high tibial osteotomy (MOWHTO), the goal extends beyond lateralizing the mechanical axis; restoring a horizontal joint line is crucial for optimal biomechanics. The Coronal Plane Alignment of the Knee (CPAK) classification, which incorporates mechanical axis deviation and joint line obliquity (JLO), offers a phenotype-based framework, though its application in MOWHTO remains underexplored.

MATERIALS AND METHODS: A retrospective review included 147 knees from 123 patients undergoing MOWHTO with at least 24 months of follow-up. Radiographic parameters assessed were mFTA, MPTA, mLDFA, JLCA, aHKA, and JLO. Knees were categorized based on postoperative weight-bearing line (WBL) positions, and CPAK phenotypes were recorded pre- and postoperatively. Clinical outcomes were evaluated using the Hospital for Special Surgery (HSS) knee score.

RESULTS: Preoperatively, CPAK type I (varus, apex distal JLO) predominated (82.3%). Postoperatively, many transitioned to Types V (neutral, apex neutral JLO, 24.5%) and VI (valgus, apex neutral JLO, 17.7%), both yielding significantly higher HSS scores (p < 0.001). Optimal outcomes were observed with a WBL between 50% and 60%. The mean aHKA improved from - 7.35° to + 1.59°, while JLO corrected from 172.4° to 180.8°.

CONCLUSION: This study demonstrates that transitions to CPAK Types V-VI, with 50-60% WBL and horizontal joint line restoration, are linked to improved HSS scores, highlighting the CPAK classification's potential for guiding individualized correction strategies in MOWHTO.

LEVEL OF EVIDENCE: Level III (retrospective comparative study).

PMID:40986039 | DOI:10.1007/s00264-025-06659-1

Injury. 2025 Sep 14;56(11):112760. doi: 10.1016/j.injury.2025.112760. Online ahead of print.

ABSTRACT

INTRODUCTION: Posterior sternoclavicular joint (SCJ) dislocations are rare, accounting for <1 % of all joint dislocations. Despite their rarity, these injuries warrant urgent recognition due to the SCJ's proximity to mediastinal structures, including the trachea, esophagus, and great vessels. While not always surgical emergencies, delayed or unstable cases can result in life-threatening complications if not managed in an appropriately equipped hospital setting.

CASE PRESENTATION: A 28-year-old male presented two weeks after sustaining a right SCJ injury while sliding during a softball game. He reported persistent pain, difficulty breathing, and limited shoulder function. Initial radiographs were unremarkable; however, CT imaging revealed a posterior dislocation of the medial clavicle. Given the delayed presentation and potential mediastinal involvement, the patient underwent open reduction and internal fixation (ORIF) with cardiothoracic surgical assistance. Fixation was achieved using unicortical screws in the sternum and bicortical screws in the clavicle. He recovered without complications and returned to full activity CONCLUSION: : Posterior SCJ dislocations are challenging to diagnose on radiographs and often require CT for accurate assessment. Although closed reduction is an option in acute cases, delayed presentations typically necessitate surgical stabilization. Plate fixation offers reliable alignment and secure fixation. This case underscores the importance of timely diagnosis, hospital-based care, and multidisciplinary surgical planning when managing posterior SCJ dislocations.

PMID:40982998 | DOI:10.1016/j.injury.2025.112760

Int Orthop. 2025 Sep 22. doi: 10.1007/s00264-025-06651-9. Online ahead of print.

NO ABSTRACT

PMID:40982037 | DOI:10.1007/s00264-025-06651-9

Injury. 2025 Sep 15:112761. doi: 10.1016/j.injury.2025.112761. Online ahead of print.

ABSTRACT

INTRODUCTION: Blunt Thoracic trauma (BTT) affects over 10 % of trauma patients and may lead to delayed respiratory complications. The STUMBL (STUdy of the Management of BLunt chest wall trauma) score was developed to identify patients at high risk of complications. This study aimed to validate the STUMBL score in a Canadian setting.

METHODS: We conducted a retrospective cohort study of adult patients with isolated BTT presenting to a Canadian emergency department (ED) of a Level-1 trauma center between 2018 and 2020. STUMBL scores were calculated for each patient. The primary outcome was a composite of in-hospital mortality, early pulmonary complications, ICU admission, or prolonged hospital stay (≥7 days). Secondary outcomes were delayed pulmonary complications and unplanned return to the ED. Receiver operating characteristic (ROC) curves were used to evaluate predictive performance, and sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were computed for each score cutoff.

RESULTS: Among 344 included patients (mean age: 57.8 ± 17.0, male sex: 64.2 %), 18.3 % experienced the primary outcome. The STUMBL score showed good discrimination (AUROC 0.87). A cutoff of ≤10 yielded a sensitivity of 90.5 % and NPV of 97.0 %, while a cutoff of ≤15 showed a sensitivity of 66.7 % and NPV of 92.2 % to predict the composite outcome. In patients with a score ≤15, delayed pulmonary complications occurred in <2 %, and unplanned ED visits in <7 %. Conversely, 82.4 % of patients with STUMBL scores ≥21 experienced the composite outcome. This cutoff was associated with a specificity of 97.9 % and PPV of 82.4 %.

CONCLUSIONS: The STUMBL score demonstrated good performance in predicting early adverse outcomes in Canadian patients with isolated BTT. Patients with a STUMBL score ≤15 and no early complications represent a low-risk group that may be safely discharged. Those with scores ≥21 warrant ICU evaluation. Further prospective validation or refinement is recommended before widespread implementation.

PMID:40976766 | DOI:10.1016/j.injury.2025.112761

Injury. 2025 Sep 14;56(11):112762. doi: 10.1016/j.injury.2025.112762. Online ahead of print.

ABSTRACT

OBJECTIVE: To predict the risk of spontaneous tendon rupture (STR) in dialysis patients using a low-variable, clinically implementable model and to perform internal validation.

MATERIALS AND METHODS: In a single-centre case-control study, 102 individuals were analysed (34 STR cases, 68 controls). Pre-specified candidate predictors comprised four clinical variables: frailty (Clinical Frailty Scale, CFS), dialysis vintage, calcium-phosphate (Ca-P) product, and quinolone exposure within the past 6 months. Group comparisons were conducted; multivariable analysis used logistic regression. Discrimination and calibration were assessed with an L2-penalised approach, 5-fold cross-validation, and bootstrap optimism correction; decision curve analysis (DCA) was undertaken.

RESULTS: Compared with controls, cases had higher CFS, longer dialysis vintage, higher Ca-P product and intact parathyroid hormone (iPTH), and lower albumin; C-reactive protein did not differ materially. In the multivariable model, CFS and dialysis vintage were independently and positively associated with STR; Ca-P and quinolone coefficients were positive but did not cross conventional significance thresholds. Discrimination was good: apparent AUC 0.806 and optimism-corrected AUC 0.786; Brier score 0.247. Calibration was visually acceptable, with greater uncertainty at higher predicted probabilities. On DCA, across a 15 %-25 % risk threshold range, the model provided higher net benefit than a treat-none strategy and a net benefit comparable to a treat-all strategy. Among cases, the operative rate was 100 %, complications 11.8 %, recurrence 8.8 %, 12-month mortality 6.3 %, and median length of stay 3.7 days. Rupture sites were quadriceps in 44.1 % and patellar tendon in 32.3 %.

CONCLUSIONS: In dialysis patients, STR risk appears predictably estimable using readily obtainable indicators such as CFS and dialysis vintage. The Ca-P/iPTH axis may contribute directionally to risk, while the effect of quinolone exposure warrants confirmation in larger cohorts. The model has potential to inform clinical decision-making; further calibration refinement and external validation are recommended before routine implementation.

PMID:40976189 | DOI:10.1016/j.injury.2025.112762

Injury. 2025 Sep 4;56(11):112725. doi: 10.1016/j.injury.2025.112725. Online ahead of print.

ABSTRACT

INTRODUCTION: The reverse oblique fracture patterns accounts for about 5-10 % of all intertrochanteric fractures. This type of fracture is regarded as highly unstable and is still associated with high complication and failure rates. Cut-off values for the use of short or long implants are not yet defined. An easy-to-use and comprehensive classification system is still lacking.

MATERIALS AND METHODS: This study was performed as a single center retrospective data analysis. Between 2008 and 2018, 4003 patients with per/subtrochanteric fractures, were screened. A total of 286 (7 %) patients with a reverse-oblique fracture pattern were included. Fracture patterns were analyzed and classified according to a new classification system with 4 main types (I-IV), which are subdivided in to subtypes a and b. The choice of implants, complication rates, revision surgery and time of surgery were raised. Radiological outcome parameters (TAD, calTAD, Parker's Ratio) and loss of reduction were measured.

RESULTS: The distribution between the various subgroups was IIa and IVa (21 %), IIb (20 %), Ia (12 %), IVb (9 %), IIIa (8 %), Ib (6 %) and IIIb (3 %). A rate of 39 (14 %) complications, which needed revision surgery were recorded. Open reduction significantly increased the complication rate (p= 0.0356) as well as an increase in time of surgery (p = 0.0107). The additional use of cerclage wires had no additional influence. There was a trend to more complications after the use of a long implant in patients with type-a fractures (p= 0.056). Radiological parameters did not have any predictive value. Loss of reduction of the medial or lateral cortex shows a trend to a higher complication rate. After a primary complication, the necessity of repeating revision surgery is likely to happen.

CONCLUSION: The novel classification system depicts all relevant fracture patterns. Open reduction and prolonged time of surgery increase the complication rate. In type-a fractures, the use of short implants is recommended. Additional use of cerclage wires does not have a negative impact on outcome.

PMID:40974891 | DOI:10.1016/j.injury.2025.112725

Int Orthop. 2025 Sep 20. doi: 10.1007/s00264-025-06654-6. Online ahead of print.

ABSTRACT

PURPOSE: Rheumatoid arthritis (RA) is a systemic disorder that affects the cervical spine (CS). Synovial inflammation can disrupt spinal stability, leading to conditions such as atlantoaxial and/or subaxial subluxation, vertical settling, and combined instability. Although symptoms may appear in a minority of patients, they are commonly observed in those with advanced diseases. Myelopathy can develop in about 2.5% of patients with long-standing RA. Surgical treatment is indicated for the presence of myelopathy, progressive neurological deficit and/or chronic untreatable pain. The objective of this study is to evaluate the long-term outcomes following surgical treatment of CS involvement in patients with RA and to review the existing literature.

MATERIALS AND METHODS: The present study is a retrospective and descriptive review of 17 patients with cervical involvement caused by RA who underwent surgery between 2000 and 2022. Collected data comprised the type of cervical lesion, the surgical approach and the pre-surgical, post-surgical and current neurological status.

RESULTS: Most patients were women (70,58%) and the mean age at surgery was 51,17 years. Myelopathy was present in 12 patients at the time of surgery. Ten patients improved the post-surgical Ranawat score, while seven remained stable. One patient died from post-surgical complications (5,88% of fatal events), and four patients passed away during the follow-up period.

DISCUSSION AND CONCLUSIONS: Surgical treatment of the cervical manifestation of RA provides benefits, improving quality of life and/or detaining the progression of the neurological damage. Even though the results are encouraging, surgery is not risk-free.

PMID:40974410 | DOI:10.1007/s00264-025-06654-6

SICOT J. 2025;11:53. doi: 10.1051/sicotj/2025050. Epub 2025 Sep 19.

ABSTRACT

BACKGROUND: Correcting severe scoliosis is challenging due to curve rigidity and risks to cardiopulmonary and neurologic function. Osteotomy techniques offer greater correction but carry higher complication rates, while non-osteotomy methods may be safer but less effective. This systematic review compares outcomes between osteotomy and non-osteotomy approaches in treating severe idiopathic scoliosis.

METHODS: A systematic search was conducted in PubMed, EMBASE, and the Cochrane Library using MeSH terms related to "idiopathic adolescent scoliosis", "AIS", "severe scoliosis", and "surgical outcome". The review followed PRISMA guidelines.

RESULTS: An initial search yielded 565 studies, of which 23 studies (n = 932 patients) met the inclusion criteria. The Vertebral Column Resection (VCR) group achieved the greatest spinal correction, with a mean Cobb angle of 106.7 ± 9.7° and a correction rate of 62.1%, but also had the highest complication rate at 24%. Non-osteotomy methods provided similar correction (107.0 ± 9.1°, 61.5%) with a slightly lower complication rate of 19.6%. The Ponte osteotomy group had the lowest complication rate (4%) with a moderate level of correction (107.4 ± 10.5°, 60.3%). In terms of functional outcomes, the non-osteotomy group reported the highest SRS-22r scores, averaging 4.3.

CONCLUSION: VCR offers the most significant curve correction, but with a higher complication rate. Ponte osteotomy provides a safer alternative with acceptable clinical outcomes. In contrast, non-osteotomy techniques strike a balance between correction and risk, with favorable functional results.

PMID:40971604 | PMC:PMC12448635 | DOI:10.1051/sicotj/2025050

Injury. 2025 Sep 10;56(11):112745. doi: 10.1016/j.injury.2025.112745. Online ahead of print.

ABSTRACT

BACKGROUND: Finger defect reconstruction requires functional and aesthetic restoration. The great toenail flap demands advanced microsurgical skills. We propose a staged approach: initial pedicled flap coverage, followed by second-stage exchange of the great toenail flap with the finger flap, enhancing donor site repair while reducing complexity and expanding access in resource-limited settings.

METHOD: Sixteen patients (2017-2024) underwent staged reconstruction: primary pedicled flap followed by great toenail flap-finger flap exchange. Outcomes included complications, functional metrics (Semmes-Weinstein monofilament test, Michigan Hand Outcomes Questionnaire [MHQ], static two-point discrimination [2-PD]), and donor foot pain (Visual Analog Scale [VAS]). Healthy sides served as controls.

RESULTS: At mean 12-month follow-up, reconstructed fingers showed mean static 2-PD of 5 mm and Semmes-Weinstein result of 3.67 g; MHQ averaged 89.6. Foot donor sites demonstrated mean 2-PD of 5.5 mm and VAS of 1. Complications included partial flap necrosis (1 case) and significant donor foot pain (1 case). Interphalangeal joint motion, 2-PD, and MHQ scores differed significantly from healthy sides (p < 0.001)..

CONCLUSION: This staged protocol provides a safe, practical solution for finger reconstruction, particularly in settings with limited microsurgical resources. It reduces primary hospital treatment thresholds and addresses suboptimal aesthetic/functional outcomes.

THERAPEUTIC: Level III.

PMID:40972085 | DOI:10.1016/j.injury.2025.112745

Injury. 2025 Sep 10;56(11):112754. doi: 10.1016/j.injury.2025.112754. Online ahead of print.

ABSTRACT

INTRODUCTION: Posterior malleolus fractures are frequently associated with varying degrees of comminution. This comminution often leads to osteochondral fragment loss from the posterior articular surface of the tibial plafond. The purpose of this study is to use finite element modeling to determine whether osteochondral defects at the posterior malleolus fracture interface significantly influence tibiotalar contact stress.

METHODS: 3D models of 10 randomly selected patients were created of the tibia and talus from CT scans. A layer of cartilage was added to simulate contact at the tibiotalar joint. Different circular osteochondral defects were modeled at the fracture interface 3 mm, 5 mm, 10 mm in diameter. Two sizes of fractures were modelled (5 mm and 10 mm), from the posterior-most point on the articular tibial surface. Models with fractures and without osteochondral defects, were tested as controls. Models were loaded in finite element software under single-leg-stance at average body weight. Scenarios were repeated for maximal dorsiflexion and plantarflexion. Differences between the sizes of osteochondral defects across different fracture sizes for each ankle range of motion scenario were determined.

RESULTS: No significant differences in maximum articular contact stresses were observed between different sized osteochondral defect sizes in the 5 mm fracture size and ankle range of motion scenarios. However, significant differences in maximum articular contact stresses were observed between different sized osteochondral defect sizes with 10 mm fracture sizes. These differences were observed in neutral and dorsiflexion, but not in plantarflexion.

CONCLUSION: Larger posterior malleolus fractures with osteochondral defects, when loaded with the ankle in neutral and dorsiflexion, resulted in larger tibiotalar articular stresses.

PMID:40972084 | DOI:10.1016/j.injury.2025.112754

Injury. 2025 Sep 9;56(11):112756. doi: 10.1016/j.injury.2025.112756. Online ahead of print.

ABSTRACT

The fifth metatarsal is essential for balance control during gait and remains susceptible to proximal fractures such as the Jones fracture due to its limited vascularity, making the choice of fixation method of critical importance. The study was conducted to biomechanically compare conventional fixation techniques and identify the most effective strategy for Jones fracture management, culminating in the design and rigorous evaluation of a novel biodegradable implant. A volumetric model of the fifth metatarsal with fixation constructs was developed using medical imaging and digital design tools, and its mechanical performance was assessed by finite element analysis. The proximal end of the metatarsal bone was immobilized, and a 60 N-according to literature-was applied to the distal end; frictional interaction was incorporated at the fracture interface to simulate realistic mechanical conditions. The mechanical properties of Ti6Al4V and CrNiMo alloys were used for the implant models. The intramedullary screw model registered the lowest stress values for both materials, prompting subsequent material and design modifications. A magnesium-based biodegradable material was adopted, and mechanical analyses were conducted again following the implementation of requisite design refinements. The modified biodegradable implant was verified to provide adequate structural performance, indicating its suitability for Jones fracture fixation.

PMID:40967129 | DOI:10.1016/j.injury.2025.112756

Injury. 2025 Sep 9;56(11):112757. doi: 10.1016/j.injury.2025.112757. Online ahead of print.

ABSTRACT

BACKGROUND: Literature on quality of life and functionality following various types of surgically treated foot injuries is limited, despite the significant impact on patients' daily lives. As a result, managing patient expectations becomes challenging. The current objective is to prospectively evaluate long-term patient-reported and clinical outcomes of surgically treated foot injuries.

METHODS: A multicentre prospective cohort study was conducted. Adult patients undergoing operative treatment for traumatic foot fractures and/or dislocations were eligible for inclusion. Data on patient demographics, treatment, patient-reported outcomes (health-related quality of life assessed using the EuroQol questionnaires, functionality evaluated by the American Orthopaedic Foot and Ankle Society scales, satisfaction, and return to work/sports), complications, and reoperations were collected. Follow-up lasted two years. Statistically significant and clinically relevant changes in outcomes were determined using the Friedman test and minimally important differences.

RESULTS: The follow-up response rate was 92%. Patients showed significant and relevant differences in EuroQol scores during follow-up compared to pre-trauma, not returning to their baseline levels. The EQ-VAS™ showed clinically relevant improvement between 1 and 2 years postoperatively. Patients with forefoot injuries had better EuroQol and sports function scores, but lower satisfaction compared to those with midfoot and hindfoot injuries. The EuroQol pain domain exhibited the largest increase in reported problems, followed by usual activities, mobility, anxiety, and self-care. In the forefoot, midfoot, and hindfoot subgroups, the complication rates were 50%, 19%, and 44% respectively. Most complications were related to posttraumatic arthrosis (26%) and infections (24%). Over half of the patients (52%) underwent implant removal. The majority of reoperations involved secondary arthrodesis (37%) or revision surgery (32%).

DISCUSSION AND CONCLUSION: Strengths of this study include the prospective multicentre setting, the high response and follow-up rates, its epidemiological nature, and the inclusion of various injury types with stratified data presentation. Limitations include recall bias, suboptimal minimal important differences, group heterogeneity, and the use of the suboptimal AOFAS scales. The overview of patient-reported and clinical outcomes for patients treated surgically for acute foot injuries presented in this study show persisting impairment in functionality at the two-year follow-up. The data will help manage patient expectations effectively.

PMID:40967128 | DOI:10.1016/j.injury.2025.112757

Injury. 2025 Sep 9;56(11):112751. doi: 10.1016/j.injury.2025.112751. Online ahead of print.

NO ABSTRACT

PMID:40967127 | DOI:10.1016/j.injury.2025.112751

J Bone Joint Surg Am. 2025 Sep 17;107(18):e93. doi: 10.2106/JBJS.ER.24.01334. Epub 2025 Sep 17.

NO ABSTRACT

PMID:40960478 | DOI:10.2106/JBJS.ER.24.01334

J Bone Joint Surg Am. 2025 Sep 17;107(18):e92. doi: 10.2106/JBJS.ER.24.01480. Epub 2025 Sep 17.

NO ABSTRACT

PMID:40960477 | DOI:10.2106/JBJS.ER.24.01480

J Bone Joint Surg Am. 2025 Sep 17;107(18):e91. doi: 10.2106/JBJS.ER.24.01427. Epub 2025 Sep 17.

NO ABSTRACT

PMID:40960476 | DOI:10.2106/JBJS.ER.24.01427