J Bone Joint Surg Am. 2025 Jul 1. doi: 10.2106/JBJS.25.00471. Online ahead of print.

NO ABSTRACT

PMID:40591698 | DOI:10.2106/JBJS.25.00471

J Bone Joint Surg Am. 2025 Jul 2;107(13):e72. doi: 10.2106/JBJS.25.00113.

NO ABSTRACT

PMID:40591353 | DOI:10.2106/JBJS.25.00113

J Bone Joint Surg Am. 2025 Jul 2;107(13):e70. doi: 10.2106/JBJS.25.00088.

NO ABSTRACT

PMID:40591263 | DOI:10.2106/JBJS.25.00088

J Bone Joint Surg Am. 2025 Jul 2;107(13):e73. doi: 10.2106/JBJS.25.00154.

NO ABSTRACT

PMID:40591261 | DOI:10.2106/JBJS.25.00154

J Bone Joint Surg Am. 2025 Jul 2;107(13):e71. doi: 10.2106/JBJS.25.00170.

NO ABSTRACT

PMID:40591255 | DOI:10.2106/JBJS.25.00170

J Bone Joint Surg Am. 2025 Jun 30. doi: 10.2106/JBJS.25.00152. Online ahead of print.

NO ABSTRACT

PMID:40587605 | DOI:10.2106/JBJS.25.00152

Int Orthop. 2025 Jun 30. doi: 10.1007/s00264-025-06587-0. Online ahead of print.

NO ABSTRACT

PMID:40586928 | DOI:10.1007/s00264-025-06587-0

Int Orthop. 2025 Jun 30. doi: 10.1007/s00264-025-06594-1. Online ahead of print.

ABSTRACT

PURPOSE: Presoaking of hamstrings autograft in vancomycin solution has been associated with significant reduction of post-operative septic arthritis rate after anterior cruciate ligament (ACL) reconstruction. The purpose of this study was to evaluate this effect by comparison of cohorts from the single-centre database.

METHODS: In a period between January 2018 and November 2023, 1329 patients underwent ACL reconstruction surgery at our institution, with a newly introduced technique of soaking the hamstrings autografts in a 5-mg/ml vancomycin solution. Data was retrospectively analysed to identify post-operative knee septic arthritis rate amongst this group. Results were compared with the results from our previous study, which included 1891 patients from January 2007 to December 2017, when ACL reconstruction surgery was made at our institution without soaking the autografts in vancomycin solution.

RESULTS: Results showed that one (0,07%) out of 1329 patients who underwent ACL reconstruction with vancomycin-soaking of the graft developed knee joint infection after the surgery, while using the old method the infection rate was 1,4%. Statistical analysis showed that there is a significant difference in the infection rate between two groups (OR, 0,05 [95% CI, 0.0073-0.3982]; p < 0.01).

CONCLUSION: Presoaking of the hamstrings graft for ACL reconstruction in 5 mg/ml vancomycin solution as an addition to standard pre-operative intravenous antibiotic prophylaxis is associated with significant reduction of post-operative infection rate.

PMID:40586927 | DOI:10.1007/s00264-025-06594-1

Injury. 2025 Jun 23;56(8):112543. doi: 10.1016/j.injury.2025.112543. Online ahead of print.

ABSTRACT

BACKGROUND: Tibial plateau fractures (TPFs) are complex injuries associated with significant postoperative complications including infection, deformity and wound healing disorders. Limited data exist on risk factors for complications following surgical treatment, particularly in large multicenter cohorts.

METHODS: This retrospective study analyzed 1027 patients with intra-articular TPFs treated surgically at two level-I trauma centers in Germany (2011-2020). Preoperative CT imaging and follow-up data were required for inclusion. Complications were categorized into seven groups (infection, deformity, wound healing disorders, postoperative compartment syndrome, range of motion deficit and others). Statistical analyses assessed associations with fracture type (Schatzker classification), surgical approach, duration, and patient factors (BMI, age, smoking).

RESULTS: Nineteen percent of patients required surgical revision, with deformity (5.7 %), infection (5.4 %), and wound healing disorders (3.3 %) being the most common complications. Complex fractures (Schatzker V-VI) and prolonged or multi-approach surgeries were associated with higher complication rates. Elevated BMI increased overall complication risk, while smoking was linked to wound healing disorders.

CONCLUSION: The 19 % revision rate highlights the challenges of managing TPFs. Surgical factors, including operative duration and approach, play a critical role in the occurrence of complications, emphasizing the need for tailored strategies based on fracture complexity and surgical considerations.

PMID:40577996 | DOI:10.1016/j.injury.2025.112543

Injury. 2025 Jun 23;56(8):112550. doi: 10.1016/j.injury.2025.112550. Online ahead of print.

ABSTRACT

Introduction Geriatric fractures are a major contributor of morbidity and mortality in elderly patients and represent a large resource burden on healthcare institutions across the United States. Elderly populations are predicted to increase in the coming decades, motivating epidemiological studies that may inform more effective and targeted prevention measures for these injuries. Methods Data analyzed in this study was extracted from the National Electronic Injury Surveillance System (NEISS), a public database representing approximately 100 US EDs to provide national injury estimates. NEISS was queried for all fracture ED admissions among patients age 65 and older. Fracture events were restricted to injuries from January 1, 2019 to December 31, 2023. Results A geriatric fracture NEISS query resulted in 82,953 ED visits, extrapolating to a total national estimate of 3852,261 fractures presenting to US EDs across the study period. The overall hospitalization rate was 54.8 %, increasing to 74.5 % by age 99. Linear regression of fractures rates by year demonstrated a significant increase in male fractures over time (p = 0.047, β = 7688). Compared to females, males were also more likely to sustain trunk fractures and become injured at sporting facilities. Older patients also saw higher rates of trunk fractures (including upper and lower trunk), while rates of extremity fractures (upper and lower extremities) decreased with age. Fractures in the home also decreased with age, while those occurring on public property (including assisted living facilities) increased with age. Conclusion Increasing fracture rates among males indicates an opportunity for improved prevention measures among men 65 and older. Males were also more likely to sustain fractures while participating in sports, and may therefore benefit from education programs on fracture risk. Geriatric fractures were more likely to occur on public property such as sidewalks and assisted living facilities as patients aged, demonstrating the need for improved precautionary measures such as low-floor beds, hip protectors, fall alarms, and wearable devices.

PMID:40577995 | DOI:10.1016/j.injury.2025.112550

J Bone Joint Surg Am. 2025 Jun 27. doi: 10.2106/JBJS.25.00008. Online ahead of print.

NO ABSTRACT

PMID:40577440 | DOI:10.2106/JBJS.25.00008

Injury. 2025 Jun 17:112521. doi: 10.1016/j.injury.2025.112521. Online ahead of print.

ABSTRACT

INTRODUCTION: Over the past two decades, damage control laparotomy and resuscitation (DCL and DCR, respectively) have become the dominant paradigms for the management of exsanguinating trauma. Fascial complications are common after DCL. Minimizing crystalloid administration is a key component of DCR, but there is little direct evidence that it reduces fascial complications. This study was designed to test the hypothesis that lower crystalloid administration volume during the perioperative period for DCL is associated with an increase in fascial closure rates and a decreased rate of fascial dehiscence.

METHODS: This was a retrospective observational study at a single urban trauma center. Adult trauma patients who underwent emergent DCL between March 2019 - December 2022 were included. Patients who died within 7 days of definitive closure or underwent additional intracavitary operations (e.g., thoracotomy) before or concurrent with laparotomy were excluded. Risk factors for fascial dehiscence and planned ventral hernia (PVH) were evaluated using univariate and multiple logistic regression analysis.

RESULTS: Among 287 included patients, median age was 32 (IQR 23-44), median injury severity score (ISS) 25 (17-34), median base deficit 6 (2-9), and 56.1 % had penetrating mechanism. The median crystalloid intravenous fluid (IVF) received from prehospital period to 48 h after index operation was 16.3 L (13.0-20.1 L). ISS, base deficit, and vital signs (systolic blood pressure, heart rate, and respiratory rate) did not differ between patients discharged with PVH or primary fascial closure, nor between patients who experienced a documented dehiscence event versus those who did not. Crystalloid volume was statistically different across both comparisons (primary fascial closure vs PVH at discharge: 15.6 vs 20.5 L, p < 0.001; no dehiscence vs any dehiscence 15.0 vs 18.1 L, p < 0.001). By multiple logistic regression, early IVF administration was associated with both PVH at discharge (odds ratio (OR) 1.14, 95 %CI 1.07-1.23) and fascial dehiscence (OR 1.17, 95 %CI 1.04-1.20).

CONCLUSION: Increased volume of perioperative crystalloid is associated with higher risk of fascial complications among patients requiring DCL for trauma. The DCR paradigm may reduce surgical complications as well as mortality among patients with severe trauma requiring laparotomy.

PMID:40571541 | DOI:10.1016/j.injury.2025.112521

Injury. 2025 Jun 17;56(8):112528. doi: 10.1016/j.injury.2025.112528. Online ahead of print.

ABSTRACT

This study reported the development of a novel mouse model for full-thickness articular cartilage defects. A total of 120 C57BL/6 mice were assigned to a sham group and three defect groups. The defect groups included D0.1, D0.2, and D0.3 groups, with 0.1, 0.2, and 0.3 mm wide full-thickness defects in the femoral trochlear grooves, respectively. The reproducibility and consistency of full-thickness defects and cartilage repair were evaluated by histological examination. The mRNA and protein expression levels of cAMP response element binding protein (CREB), phosphorylated CREB (p-CREB), parathyroid receptor 1 (PTH1R), Sonic hedgehog (Shh), Smoothened (Smo), and Gli 1 were assessed by immunohistochemistry and qRT-PCR. The results showed that the full-thickness defects displayed good reproducibility and consistency. Injury widths of 0.1 and 0.2 mm presented superior repair abilities than 0.3 mm (p < 0.05). During cartilage repair, the expression levels of PTH1R, CREB, p-CREB, Shh, Smo, and Gli 1 in the three defect groups were significantly higher than in the sham group (p < 0.05). In addition, the PTH/PTHrP and Hh signaling pathways were activated. In conclusion, we successfully established a novel mouse model for full-thickness articular cartilage defects, which enables deeper exploration of the biological mechanisms involved in cartilage repair in mice.

PMID:40570648 | DOI:10.1016/j.injury.2025.112528

Injury. 2025 Jun 6;56(8):112440. doi: 10.1016/j.injury.2025.112440. Online ahead of print.

ABSTRACT

INTRODUCTION: Controversy surrounds the optimal surgical management of proximal humerus fractures (PHFs). The aim of this study was to evaluate and compare the anatomic and clinical outcomes of open reduction internal fixation (ORIF) of PHFs using FA or VA locking plates.

METHODS: This was a retrospective study of 85 patients (19 male, mean age 60.5 ± 14 years) with displaced surgical neck PHFs treated with VA (44 patients) or FA (41 patients) locking plates. Inclusion criteria were a minimum of 1 year postoperative follow up (mean 3.1 years) or earlier revision surgery. Outcome measures included active range of motion, American Shoulder and Elbow Surgeons (ASES) score, Oxford Shoulder Score (OSS), Single Assessment Numeric Evaluation (SANE), EuroQol-5D (EQ-5D), Visual Analog Scale Pain score (VAS pain) and radiographic assessments of reduction quality, screw position, avascular necrosis (AVN) and failure of fixation.

RESULTS: The initial reduction was anatomic in 47 (55 %), acceptable in 29 (34 %), and malreduced in 9 (11 %). 69 (81 %) met inclusion criteria with no differences in reduction quality between the VA and FA plates (p=.16). VA plating was associated with significantly greater plate height compared to FA plating (B = 4.94; p<.001). Additionally, VA plating was associated with better calcar screw placement in terms of both shorter calcar distance (difference in means =1.8 mm, p=.009) and head distance (difference in means=2.4 mm, p=.007). Reoperation was required in 15 (22 %) patients while AVN occurred in 13 (19 %) patients. Neither reoperation nor AVN differed by plate type (p=.75 and p=.99, respectively). Finally, there were no significant differences in PROMs or ROM at final follow up between groups (difference in mean ASES: 1.1, p=.69; OSS: 1.4, p=.76; SANE: 6.5, p=.07; VAS Pain: 0.1, p=.35; EQ-5D: 0.02, p=.68; Active Forward Flexion: 2.3 degrees, p=.77; Active External Rotation: 6.7 degrees; Active Internal Rotation: 0.8, p=.55).

CONCLUSIONS: ORIF of PHFs with VA locking plates yields comparable outcomes to FA plates while facilitating plate positioning and calcar screw placement. Optimizing fracture reduction and fixation when performing ORIF of displaced PHFs is crucial to reducing the incidence of AVN and reoperation.

LEVEL OF EVIDENCE: Level III, Comparative Cohort Series, Treatment Study.

PMID:40570647 | DOI:10.1016/j.injury.2025.112440

J Bone Joint Surg Am. 2025 Jun 26. doi: 10.2106/JBJS.24.01081. Online ahead of print.

ABSTRACT

BACKGROUND: AAOS Clinical Practice Guidelines recommend spica casting for the treatment of most femoral fractures in children 6 months to 5 years of age. The purpose of the present study was to compare the outcomes of treatment with prefabricated braces with those of spica casting.

METHODS: We performed a randomized prospective study of patients 6 months to 5 years of age who were managed with functional bracing or spica casting for the treatment of diaphyseal femoral fractures at 2 pediatric trauma centers. Patients with polytrauma, medical comorbidities impacting fracture-healing, or <6 weeks of follow-up were excluded. Spica casts were placed in the operating room with the patient under anesthesia. Functional braces were placed at bedside.

RESULTS: Eighty patients (40 in the spica casting group and 40 in the functional bracing group) met the inclusion criteria and were analyzed. The mean age was 2.0 years in the casting group and 2.3 years in the bracing group (p = 0.15). Radiographs demonstrated similar shortening (9.0 ± 7.6 mm in the casting group and 6.8 ± 8.2 mm in the bracing group; p = 0.21), varus angulation (9.0º ± 11.9º in the casting group and 5.6º ± 9.4º in the bracing group; p = 0.19), and procurvatum (9.4º ± 12.9º in the casting group and 6.7º ± 8.4º in the bracing group; p = 0.31). At 6 weeks, there were no differences in shortening (13.1 ± 9.4 mm in the casting group and 11.0 ± 10.0 mm in the bracing group; p = 0.35), varus angulation (2.4º ± 7.3º in the casting group and 5.3º ± 6.3º in the bracing group, p = 0.06), or procurvatum (12.3º ± 9.8º in the casting group and 9.1º ± 8.1º in the bracing group; p = 0.11). Fifty-one patients (24 in the casting group and 27 in the bracing group) had 1 year of follow-up. There were no differences between the groups in terms of shortening (4.9 ± 5.4 mm in the casting group and 3.0 ± 6.9 mm in the bracing group; p = 0.23) or varus angulation (1.8º ± 3.5º in the casting group and 1.2º ± 4.1º in the bracing group; p = 0.56), but there was a slight difference in procurvatum (11.7º ± 8.3º in the casting group and 5.1º ± 5.8º in the bracing group; p < 0.01). More superficial skin issues were observed in the bracing group than in the casting group (9 compared with 1; p = 0.02), but all skin issues resolved with local wound care. Patients in the casting group had more difficulty moving independently (median score, 8 of 10 in the casting group and 5 of 10 in the bracing group; p = 0.05). Patients in the bracing group were more likely to fit into their car seat (40% in the casting group versus 86% in the bracing group; p < 0.01).

CONCLUSIONS: In this prospective randomized trial, patients who were treated with functional bracing had equivalent outcomes to those who were treated with spica casting. Prefabricated functional braces provided a viable alternative, avoiding the cost and anesthesia associated with cast placement.

LEVEL OF EVIDENCE: Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.

PMID:40570075 | DOI:10.2106/JBJS.24.01081

J Bone Joint Surg Am. 2025 Jun 26. doi: 10.2106/JBJS.24.01554. Online ahead of print.

ABSTRACT

Leadership selection in the field of orthopaedic surgery takes place in many settings, including national, regional, and local associations; academic departments; and private practice groups. In general, there is neither a consistent method of competency-based leadership selection nor a codified set of criteria by which to identify a successful leader in national organizations. This can potentially lead to leadership based on personality rather than process. Polling results among the orthopaedic leaders who were present at the 2024 American Orthopaedic Association (AOA) Annual Meeting Symposium revealed that 80% think that the selection process for board leadership for national orthopaedic organizations needs to improve, and 75% think that the selection process for academic department chairs also needs to improve. This summary of the 2024 AOA Symposium provides a strategy for consistent, competency-based leadership selection in orthopaedic organizations, identifies potential key selection criteria that are necessary to identify talent, and enumerates steps that can be used by nominating or search committees. Although the focus of this work is directed toward the process that is used to identify leaders for national orthopaedic organizations, features of academic medical leadership and corporate talent selection will be highlighted for consideration and translation to the orthopaedic community.

PMID:40570068 | DOI:10.2106/JBJS.24.01554

Int Orthop. 2025 Jun 26. doi: 10.1007/s00264-025-06593-2. Online ahead of print.

ABSTRACT

PURPOSE: We investigated whether neurologic and psychiatric disorders (ICD-10 F00-F99, G00-G99) increase postoperative complications and mortality after hip arthroplasty and identified subgroups with distinct complication patterns, including dislocations, loosening, fractures, and elevated mortality.

METHODS: We analyzed 190,340 primary cementless hip arthroplasties from the German Arthroplasty Registry (2012-2024). Patients with relevant diagnoses were compared to matched controls (1:1 Mahalanobis distance) across subgroups F00-F99 and G00-G99, adjusting for age, sex, BMI, Elixhauser Index, and arthroplasty type. Primary endpoints were implant survival (time to revision) and all-cause mortality over up to eight years. Revision causes including periprosthetic fracture, infection, dislocation, loosening, and others were systematically recorded.

RESULTS: Most subgroups showed significantly higher revision rates (p < 0.0001 for F00-F09, F10-F19, F30-F39, G20-G26, G40-G47, G60-G64). Mortality was also significantly higher (p < 0.0001 for F00-F09, F10-F19, F30-F39). Schizophrenia (F20-F29) increased revision (p < 0.0001) and mortality (p < 0.0001). Organic mental disorders (F00-F09) showed markedly elevated revision and mortality rates, with more frequent dislocations and fractures (p < 0.0001). Extrapyramidal disorders (G20-G26) mainly increased dislocation risk (p = 0.00032), while degenerative diseases (G30-G32) raised mortality (p < 0.0001). Episodic/paroxysmal disorders (G40-G47) increased loosening (p = 0.0041) and revision (p < 0.0001). Polyneuropathies (G60-G64) were linked to joint instability and dislocations (p = 0.0008).

CONCLUSION: Neurologic and psychiatric disorders significantly elevate revision and mortality risks following hip arthroplasty. Subgroup-specific vulnerabilities, dislocations/fractures (F00-F09), high complication and mortality (F10-F19), and joint instability (G60-G64), highlight the need for individualized perioperative strategies and close postoperative monitoring to improve outcomes.

PMID:40569372 | DOI:10.1007/s00264-025-06593-2

Injury. 2025 Jun 18:112527. doi: 10.1016/j.injury.2025.112527. Online ahead of print.

ABSTRACT

BACKGROUND: Evidence-based clinical practice guidelines play a crucial role in supporting clinical decision-making among healthcare providers, policymakers, and administrators by offering structured, research-informed recommendations. Globally, numerous guidelines have been developed for the management of burn injuries, but they vary considerably in terms of quality, structure, and methodological rigor. This study aimed to critically evaluate the quality of existing burn care guidelines from an interprofessional perspective and assess their adaptability for use in low- and middle-income countries (LMICs).

METHODS: This appraisal study, conducted between 2024 and 2025, employed the AGREE II instrument to evaluate guideline quality through the lens of an interprofessional burn care team. The methodology involved a systematic search to identify relevant guidelines, the formation of a multidisciplinary panel of burn care professionals, and a final quality appraisal of the selected guidelines using the AGREE II framework.

RESULTS: Out of the 38 initially identified clinical guidelines, 31 were excluded due to failure to meet the preliminary thresholds for quality and methodological validity. The remaining seven guidelines were subjected to a comprehensive evaluation using the 23-item AGREE II instrument, encompassing six key quality domains. The appraisal revealed considerable variability across these domains, with particularly marked disparities in stakeholder involvement, methodological rigor, and practical applicability.

CONCLUSION: The findings revealed significant heterogeneity in both the structural and content quality of current burn care guidelines. Among the evaluated documents, the guideline developed by the International Society for Burn Injuries (ISBI) achieved the highest AGREE II scores, demonstrating a strong interprofessional focus and relevance to LMICs. The expert panel subsequently endorsed it as the most appropriate candidate for adaptation in resource-constrained settings. These results highlight the urgent need for more robust, interdisciplinary, and context-sensitive burn care guidelines to improve patient outcomes and healthcare delivery globally.

PMID:40562590 | DOI:10.1016/j.injury.2025.112527

Injury. 2025 Jun 18:112525. doi: 10.1016/j.injury.2025.112525. Online ahead of print.

ABSTRACT

BACKGROUND: Rib fractures are common after blunt chest trauma and are associated with significant morbidity, mortality, and prolonged hospital stays due to pulmonary complications. Effective pain management is crucial in preventing these complications. The 'STUdy of the Management of BLunt chest wall trauma' (STUMBL) score can identify patients with rib fractures at risk of complications and assist with Emergency Department (ED) disposition decisions. Its role in guiding Acute Pain Service (APS) and Intensive Care Unit (ICU) referrals was previously unexplored.

DESIGN AND OBJECTIVES: We conducted a retrospective cohort study on adults with radiologically confirmed rib fractures who presented to The Royal Melbourne Hospital between April 2021 and March 2022. We aimed to assess the association between STUMBL scores and advanced analgesia prescription or ICU admission. Participants were categorised into five STUMBL groups (<11, 11-20, 21-25, 26-30, ≥31). The primary outcome of interest was regional analgesia insertion. The secondary outcomes were patient-controlled analgesia (PCA) use, APS and ICU referrals, and medical emergency team (MET) calls within 48 h. Modified Poisson regression was used to analyse associations, with the <11 group used as the reference.

RESULTS: Among 344 participants, the median STUMBL score was 17 (interquartile range [IQR] 10-24). Higher STUMBL scores were strongly associated with regional analgesia insertion in the STUMBL 26-30 group (RR 15.3, 95 % CI 1.8-130.3, p = 0.013) and the STUMBL ≥31 group (RR 29.3, 95 % CI 4.0-212.5, p = 0.001). Significant associations were also observed for PCA prescription (RR 5.0, 95 % CI 2.6-9.7, p < 0.001), APS referral (RR 4.7, 95 % CI 2.7-8.1, p < 0.001), and ICU admission (RR 3.8, 95 % CI 2.0-6.9, p < 0.001) in the STUMBL ≥31 group.

CONCLUSION: The STUMBL score is a valuable tool for identifying patients likely to require advanced analgesia and APS input, with high scores strongly associated with regional analgesia insertion and PCA prescription. Additionally, patients with STUMBL scores ≥26 were more likely to require ICU admission. Incorporating STUMBL thresholds into rib fracture guidelines could facilitate early APS involvement, guide appropriate admission destinations, optimise hospital resource allocation and improve patient outcomes. Further studies should validate these findings in larger, multi centre cohorts and explore patient-reported outcomes.

PMID:40562589 | DOI:10.1016/j.injury.2025.112525

Injury. 2025 Jun 19;56(8):112538. doi: 10.1016/j.injury.2025.112538. Online ahead of print.

ABSTRACT

AIM: Friction burns are a common paediatric injury that can result in significant morbidity and long-term disability. This systematic review aimed to evaluate the management and outcomes of these injuries.

METHODS: A protocol was developed a priori and registered on the PROSPERO database (CRD42022376782). A comprehensive search of MEDLINE, EMBASE, CENTRAL, CINAHL and trial registries was conducted to identify studies evaluating the management and outcomes of paediatric upper limb friction injuries. Primary outcome measures were healing time, functional outcomes, and the need for surgical intervention. Secondary outcomes included complications such as problematic scarring and cost.

RESULTS: Twenty-two studies met the inclusion criteria, encompassing 842 paediatric patients with upper limb friction injuries, predominantly treadmill-related (95 %). Most injuries (58.7 %) were deep partial-thickness to full-thickness. Conservative management with dressings was the primary treatment in 70.4 % of cases, while 29.6 % underwent acute surgery, predominately full-thickness skin grafting followed by split-thickness skin grafting. Mean healing times ranged from 19.4 to 31.5 days. Problematic scarring affected 20.5 % of patients, with 38.3 % of this group undergoing further scar revision surgery. Functional outcomes were generally positive, with minimal long-term disability reported.

CONCLUSION: Paediatric upper limb friction injuries, particularly those caused by treadmills, have typically been managed conservatively, with good functional outcomes. However, deeper injuries and delayed healing increase the risk of problematic scarring and need for scar revision surgery. Further research is needed to standardise treatment protocols and minimise long-term complications.

PMID:40561811 | DOI:10.1016/j.injury.2025.112538