Injury. 2025 Oct 26;56(12):112848. doi: 10.1016/j.injury.2025.112848. Online ahead of print.

ABSTRACT

INTRODUCTION: To analyze the anatomy of the sternum and manubrium with a focus on the proximity of vital posterior structures to provide surgeons with guidelines for screw length and to increase awareness of locations for the safest hardware placement.

MATERIALS AND METHODS: A retrospective chart review was conducted at a level one trauma center in the southeastern United States. Patients with a chest CT in 2022 without evidence of abnormalities or prior cardiac or thoracic surgery, chest trauma, or sternotomy were included in the study. The primary study measures were dimensions of the manubrium and sternum and distances to nearby structures including the right atrial appendage, the main pulmonary artery, ascending aorta, right brachiocephalic artery, superior vena cava, and left and right brachiocephalic veins.

RESULTS: 20 male (mean body mass index 29.0, mean age 50.5) and 20 female (mean body mass index 28.9, mean age 64.7) subjects were included. The smallest depth measurements of the manubrium and sternum were 10.3/9.3 mm (male/female) and 10.1/9.2 mm (m/f), respectively. The closest structures behind the manubrium were the left and right brachiocephalic veins with mean distances of 9.8/6.3 mm (m/f) and 15.5/13.5 mm (m/f), respectively. This was followed by the right brachiocephalic artery with mean distances of 20.9/16.4 mm (m/f). The closest structure behind the sternum was the right ventricle with mean distances of 8.5/8.4 mm (m/f), then the right atrial appendage with mean distances of 24.6/21.4 mm (m/f). Inter-rater reliability exceeded 0.80, indicating good reliability.

DISCUSSION AND CONCLUSION: Proximity of vital structures behind the sternum and manubrium creates challenges for bicortical screw fixation of the sternum and manubrium. Females had shorter distances indicating greater potential for injury. Understanding locations of vital structures can assist in preoperative planning and decrease complications.

PMID:41207000 | DOI:10.1016/j.injury.2025.112848

Int Orthop. 2025 Nov 8. doi: 10.1007/s00264-025-06669-z. Online ahead of print.

ABSTRACT

PURPOSE: To compare, in two groups of patients, the prognosis of unplanned resections of soft tissue sarcomas treated in a specialised centre, in terms of survival, local recurrence and complications.

METHODS: A retrospective investigation was performed between 2006-2016. A total of 191 patients were included. 147 (77%) were included in the control group (planned reactions) and 44 (23%) corresponded to the study group (unplanned resection). The control group, patients underwent primary limb salvage surgery by the orthopaedic oncology team and the study group those who were initially treated at another center and required a second oncologic surgery to achieve free margins. Overall survival, local recurrence, postoperative complications and prognostic factors were analyzed.

RESULTS: Overall survival at five years was 67% (95% CI: 62-76%). Compared to both groups, there was no significant difference (p = 0.22). The risk of LR at five years was 19.1% (95% CI: 18.89-19.30) for the control group and 35.64% (95% CI: 34.56-36.11) for the control group. for the study group (p = 0.047). Postoperative complications were significantly higher in the study group, 45% versus 21% (p < 0.01). We found a greater number of small tumours in the unplanned resection group.

CONCLUSIONS: Unplanned resection of extremity soft tissue sarcomas does not affect the overall survival of patients, but has a higher risk of local recurrence, a higher risk of developing postoperative complications and a lower chance of limb preservation. This study underscores the importance of thorough preoperative evaluation, particularly for small (< 5 cm) soft tissue tumours of the limb, and supports referral to specialised centres for optimal management.

PMID:41204953 | DOI:10.1007/s00264-025-06669-z

Injury. 2025 Oct 31:112876. doi: 10.1016/j.injury.2025.112876. Online ahead of print.

ABSTRACT

BACKGROUND: Vascular injury is a major risk factor for acute and delayed haemorrhage in blunt solid organ trauma. However, the natural history, including spontaneous resolution, remains poorly described. This study evaluated the incidence, detection timing, treatment, spontaneous resolution, and outcomes of vascular injury in high-grade blunt solid organ trauma.

METHODS: A retrospective cohort study of patients with Grade III or higher splenic, hepatic, or renal injuries (2018-2023) at Western Australia's single adult major trauma centre was conducted. We recorded rates of surgery, angioembolisation, delayed haemorrhage, and the development and regression of vascular injury.

RESULTS: 460 patients with 487 high grade solid organ injuries were admitted during the study period. Vascular injury was noted in 62.2 % of splenic injuries (n = 145/233); 24.1 % of hepatic injuries (n = 32/133) and 21.5 % of renal injuries (n = 26/121). Successful angioembolisation occurred in 61.4 % of splenic vascular injury (n = 89), 10/32 liver vascular injury and 8/26 renal vascular injury. 19 splenectomies were performed (8.2 %). Untreated vascular injury was reported in 41 splenic injuries (28.3 % of vascular injury); 13 hepatic and 15 renal injuries. Three cases of delayed haemorrhage occurred, two splenic and one hepatic; there were no clear uniting factors.

CONCLUSION: Vascular injury is common in high-grade blunt solid organ trauma, particularly splenic injury. Interval inpatient imaging detects clinically relevant new vascular injury, and a substantial proportion resolve without intervention. Given the low delayed haemorrhage rate, universal post-discharge follow-up imaging seems excessive.

PMID:41206267 | DOI:10.1016/j.injury.2025.112876

Injury. 2025 Nov 3:112863. doi: 10.1016/j.injury.2025.112863. Online ahead of print.

NO ABSTRACT

PMID:41206266 | DOI:10.1016/j.injury.2025.112863

Injury. 2025 Oct 31;56(12):112866. doi: 10.1016/j.injury.2025.112866. Online ahead of print.

ABSTRACT

AIMS: The aim of this study was to assess the safety and the union rate when cancellous bone graft was harvested directly from non-union site using the Reamer-Irrigator-Aspirator (RIA) in femoral and tibial non-unions with intramedullary nail (IMN) fixation. Our hypothesis was that harvesting from the same site would yield similar results to the conventional RIA technique in terms of union and complication rates, with a single reaming thus restricting the morbidity to a single site.

MATERIALS AND METHODS: Data was retrospectively analyzed from a single tertiary care center. We included 116 reconstruction surgeries in 116 patients, performed between January 1st 2015 and January 31st 2023. Seventy-one were mechanical non-unions (61.2 %) while forty-five were attributable to a septic origin (38.8 %). Patients went through either a one or two-step procedure depending on their infectious status. The mean age at inclusion was 40.6 years (SD = 17.1) with 81.0 % of patients being males (n = 94). The mean follow-up was 41.2 months (SD = 27.9).

RESULTS: Out of the 116 non-unions, 105 (90.5 %) had radiological union at last follow-up. Mean union duration was 7.8 months (SD = 4.0), with 56.9 % of patients resuming physical activities and 70 % returning to their previous occupation. Mean Lower Extremity Functional Scale was 56.2 points (SD = 20.9). Succes rate for mechanical non-unions was 93.0 % versus 88.7 % for septic non-unions (p = 0.33). Debridement, antibiotics and implant retention (DAIR) was necessary for 14 patients and sufficient to cure 9 out of 14. No septic shock, no tibial/femoral fracture and no embolism were noted.

CONCLUSION: When done according to our protocol, harvesting cancellous bone graft directly from non-union site using the RIA system is a safe technique, with high union rate and great functional recovery.

PMID:41205244 | DOI:10.1016/j.injury.2025.112866

Injury. 2025 Oct 30;56(12):112853. doi: 10.1016/j.injury.2025.112853. Online ahead of print.

NO ABSTRACT

PMID:41205243 | DOI:10.1016/j.injury.2025.112853

Injury. 2025 Nov 7;56(12):112870. doi: 10.1016/j.injury.2025.112870. Online ahead of print.

ABSTRACT

PURPOSE: Volar plate fixation under C-arm fluoroscopy is common in treating distal radius fractures in adults. Limiting live fluoroscopy is recommended as a theoretically simple and effective way of reducing radiation exposure by lowering the dose area product; however, real-world data are absent. This study aims to show which factor influences radiation exposure time and whether it is safe to abandon cine sequences in volar locking plate fixation procedures.

METHODS: This was a retrospective case-control study of distal radius fractures fixed with volar locking plates from 2018 to 2022. During the first period, six orthopaedic surgeons performed the surgery with their preferred fluoroscopy methods. During the second period, the single-shot technique was instructed, where surgeons avoided dynamic video imaging under fluoroscopy. Data collected include fluoroscopy time, operative time, fracture classification according to Association of Osteosynthesis (AO) criteria, post-operative radiographic changes of the radius, and patient demographic information.

RESULTS: During the first period, 59 cases were included in the study. Radiation exposure time did not correlate with time elapsed from fracture to surgery, AO fracture classification or post-operative radiographic changes. Operative time and patients' body mass index showed a weak positive correlation with radiation exposure time. Significantly differing radiation exposure times were observed among surgeons. The surgeon with the shortest exposure time employed the single-shot technique. On the other hand, the surgeon with the longest exposure time continuously pressed the pedal. During the second period, 63 cases were included in the study and irradiation time decreased from a median of 159 seconds to 19.5 seconds. Three cases required implant removal due to complications in each period.

CONCLUSIONS: Behaviours and attitudes toward fluoroscopy vary among surgeons. The single-shot technique reduced the radiation exposure time during volar locking plate implantation without an associated increase in plate removal to manage a complication.

PMID:41205242 | DOI:10.1016/j.injury.2025.112870

Injury. 2025 Oct 31:112869. doi: 10.1016/j.injury.2025.112869. Online ahead of print.

NO ABSTRACT

PMID:41203538 | DOI:10.1016/j.injury.2025.112869

Injury. 2025 Oct 31;56(12):112861. doi: 10.1016/j.injury.2025.112861. Online ahead of print.

ABSTRACT

BACKGROUND: Occupational injuries continue to be a significant health problem worldwide. The aim of this study is to define the epidemiological characteristics of occupational injuries and to evaluate their relationship with obstructive sleep apnea (OSA) and daytime sleepiness.

METHODS: This cross-sectional study included consenting patients who were admitted to Balıkesir Atatürk City Hospital Emergency Service due to occupational injuries between April-June 2024. The questionnaire form was used as a data collection tool and consisted of sociodemographic characteristics, clinical characteristics, work-related characteristics, previous occupational injuries, Epworth Sleepiness Scale, and Berlin Questionnaire. SPSS program was used for data entry and analysis. Descriptive statistics are presented as percentage, mean, standard deviation, median, minimum, and maximum values. Fisher's Exact test and Mann-Whitney U test were used in the analyses. Statistical significance value was accepted as p < 0.05.

RESULTS: During the study period, 101 out of 325 occupational injury admissions consented to participate in the study. Of the participants 32.7 % were female and the mean age of all participants was determined as 39.9 years(±10.3). Of the participants 31.7 % stated that they had previously sustained an occupational injury before the current admission and 44.6 % of them stated that they worked night shifts. According to the Berlin Questionnaire results, 9.9 % of the participants were at high risk for OSA and 5.9 % had high daytime sleepiness. 15.6 % of the 32 participants who had a prior occupational injury were at high risk for OSA while 84.4 % were at low risk. Of those who had not had an occupational injury before, 6.8 % were at high risk and 62.2 % were at low risk. There was no significant difference between the Berlin Questionnaire results according to the participants' previous occupational injury status (p = 0.281).

CONCLUSION: Occupational injuries tend to occur more frequently on Mondays and Tuesdays of the week and in male workers; furthermore, soft tissue injuries are the most common cause for emergency service admissions. Implementing educational programs and routine reminders regarding occupational safety during the start of the work week could be an effective measure to prevent these injuries.

PMID:41202587 | DOI:10.1016/j.injury.2025.112861

Injury. 2025 Oct 30;56(12):112852. doi: 10.1016/j.injury.2025.112852. Online ahead of print.

ABSTRACT

PURPOSE: Closed reduction and percutaneous pinning are the standard surgical treatment for displaced pediatric supracondylar humerus fractures. However, in some cases, open reduction is necessary. Research on this subject has not reached a consensus, and patient and fracture characteristics that can predict the need for closed or open reduction prior to treatment have not been clearly defined. In this study, we conducted a comprehensive evaluation of these characteristics with the aim of identifying variables that can predict the need for closed or open reduction.

MATERIALS AND METHODS: The study population consisted of patients aged 2 to12 years with supracondylar humerus fractures who underwent surgery at our institution's pediatric orthopedic and traumatology clinic between January 2013, and January 2021. The participants' demographic data and preoperative physical examination findings, the radiographic characteristics of the fractures, and the timing of surgery were recorded. The identified potential predictors were evaluated by multivariate logistic regression analysis.

RESULTS: Univariate analyses revealed that sex,the presence of rotation,the fracture type, the displacement direction, the fracture orientation, and the fracture subtype in the coronal plane were important factors in determining the need for closed or open reduction (P = 0.034,<0.001, 0.028,<0.001,0.001,0.007, respectively). These variables were included in a multivariate regression analysis. The multivariate model showed a 0.37-fold increase in the need for open reduction in cases of rotation (OR 0.376;CI: 0.196-0.724). A 6.36-fold increase (OR 6.359;CI: 2.540-15.920) was observed in cases where the fracture fragment was displaced posteriorly. When the fracture fragment was varus-oriented,there was a 3.85-fold increase in the likelihood of closed reduction (OR 3.848;CI: 1.506-9.831).

CONCLUSION: We found that the presence of rotation increases the likelihood that open reduction will be required for supracondylar humerus fractures.Posterior displacement of the fracture fragment and varus fracture orientation increases the likelihood of closed reduction. Hence, to achieve better clinical outcomes, we recommend that surgeons assess these factors when planning surgery for pediatric patients with supracondylar humerus fractures.

PMID:41202586 | DOI:10.1016/j.injury.2025.112852

Injury. 2025 Nov 1:112868. doi: 10.1016/j.injury.2025.112868. Online ahead of print.

ABSTRACT

We commend Bassa et al.'s study on VTE risk in acute SCI patients. We propose further exploring rehabilitation strategies, genetic polymorphisms (e.g., factor V Leiden), and inflammatory markers (e.g., CRP, IL-6) to refine personalized VTE prophylaxis and management in this population.

PMID:41198497 | DOI:10.1016/j.injury.2025.112868

Injury. 2025 Oct 31:112858. doi: 10.1016/j.injury.2025.112858. Online ahead of print.

NO ABSTRACT

PMID:41198496 | DOI:10.1016/j.injury.2025.112858

Injury. 2025 Nov 2;56(12):112864. doi: 10.1016/j.injury.2025.112864. Online ahead of print.

ABSTRACT

BACKGROUND: Open reduction and internal fixation (ORIF) is a standard treatment for lower extremity fractures, but the influence of body mass index (BMI) on postoperative outcomes is not well established. This study aims to evaluate the impact of BMI on short term and long term postoperative outcomes in patients undergoing ORIF for lower extremity fractures.

METHODS: We performed a prospective future-in-the-past cohort analysis using the TriNetX US network including adult patients undergoing lower extremity ORIF between 2003-2023 and with a minimum of 2-year follow-up. Patients were divided into obese (BMI ≥30) and nonobese (BMI <30) groups. Propensity score matching (1:1) controlled for age, race/ethnicity, and medical comorbidities. A subgroup analysis by BMI categories was also conducted. Risk ratios (RRs), 95 % confidence intervals (CIs) and p-values were calculated; categorical variables were analyzed with chi-squared tests and continuous variables with t-tests.

RESULTS: At 90 days postoperatively, patients with obesity (BMI ≥30) showed significantly increased risks of pulmonary embolism (RR 1.55, P < 0.0001), deep vein thrombosis (RR 1.30, P < 0.0001), renal failure (RR 1.217, P < 0.0001), wound disruption (RR 1.198, P = 0.017), and postoperative infections (RR 1.224, P < 0.0001) compared to nonobese patient (BMI<30). At 2 years, obesity was associated with higher risks of post-traumatic osteoarthritis (RR 1.61, P < 0.0001), malunion (RR 1.241, P = 0.001), nonunion (RR 1.293, P < 0.0001), and implant removal (RR 1.05, P < 0.002). Stratified analysis showed that complication rates rose progressively with BMI, with morbidly obese patients (BMI ≥50) having the highest risk of pulmonary embolism (RR 3.16, P = 0.001) and with severely obese patients (BMI 40-49.9) having a higher risk of mechanical failures (implant removal RR 1.21, P < 0.001). Underweight patients (BMI <18.5) had higher short-term risks of admission and pneumonia but lower long-term implant removal rates (RR 0.86, P = 0.006).

CONCLUSION: Higher BMI is significantly associated with increased short- and long-term postoperative complications following ORIF for lower extremity fractures. These findings emphasize the importance of preoperative risk assessment and postoperative monitoring in obese and severely obese patients to improve surgical outcomes.

LEVEL OF EVIDENCE: Level III, Prospective Cohort.

PMID:41197500 | DOI:10.1016/j.injury.2025.112864

Injury. 2025 Oct 31;56(12):112875. doi: 10.1016/j.injury.2025.112875. Online ahead of print.

ABSTRACT

OBJECTIVES: The optimal initial immobilization method for humeral shaft fractures remains undefined. This study evaluates whether initial emergency department (ED) immobilization type affects fracture alignment or the likelihood of requiring unplanned surgical intervention.

METHODS: Adult patients (≥18 years) with humeral shaft fractures (OTA/AO 12) treated between May 2018 and July 2023 at a single level I academic trauma center were included. Exclusion criteria were pediatric patients, open fractures (except ballistic injuries), and inadequate pre- or post-immobilization radiographs. Patients were grouped based on initial ED immobilization: posterior long-arm splint (PLA), cuff and collar sling, or coaptation splint/functional brace. The primary outcome was change in coronal and sagittal alignment following initial immobilization. Secondary outcomes included the proportion of patients achieving acceptable alignment (<30° coronal, <20° sagittal angulation) and the rate of unplanned surgical intervention despite an initial non-operative treatment plan. Multivariable regression analyses controlled for confounding variables.

RESULTS: Sixty-five patients met inclusion criteria (PLA: 22, cuff and collar: 24, functional brace/coaptation splint: 19). Groups were similar in demographics, injury mechanism, and initial alignment. Mean improvement in coronal and sagittal alignment was 8.3° and 7.3°, respectively, with no significant differences between immobilization types (p = 0.732, p = 0.623). Post-immobilization, 86.2 % of patients achieved acceptable alignment (p = 0.148). Among patients initially managed non-operatively, 10.9 % required unplanned surgery, with no significant differences between groups (p = 0.703).

CONCLUSIONS: Initial ED immobilization type does not significantly impact fracture alignment or unplanned surgical intervention. These findings support the feasibility of multiple immobilization methods, allowing patient comfort, resource availability, and cost considerations to guide decision-making.

LEVEL OF EVIDENCE: Level III.

PMID:41197499 | DOI:10.1016/j.injury.2025.112875

Int Orthop. 2025 Nov 5. doi: 10.1007/s00264-025-06688-w. Online ahead of print.

ABSTRACT

Overstuffing can be defined as too much stuff in a limited space. In anatomic shoulder arthroplasty, overstuffing is a principal cause of postoperative pain, stiffness and limited function. This article reviews the concept of overstuffing in shoulder arthroplasty and how it can be avoided.

PMID:41191070 | DOI:10.1007/s00264-025-06688-w

Int Orthop. 2025 Nov 5. doi: 10.1007/s00264-025-06679-x. Online ahead of print.

ABSTRACT

PURPOSE: To compare the clinical and functional outcomes of Ilizarov external fixation versus open reduction and internal fixation in the management of complex tibial plateau fractures.

METHODS: A prospective, randomised comparative clinical study was conducted at two trauma centres including 40 adult patients with Schatzker types IV-VI tibial plateau fractures. Patients were randomly assigned to internal fixation (n = 20) or Ilizarov external fixation (n = 20).

RESULTS: Patients in the external fixation group (Group B) started partial weight-bearing significantly earlier (mean 6.6 weeks) compared to the internal fixation group (Group A; mean 9.6 weeks; p = 0.002). Full weight-bearing was also achieved significantly sooner in Group B (mean 11 weeks) compared to Group A (mean 17.65 weeks; p < 0.001). Healing time, Knee Society Scores, pain, and range of motion were comparable.

CONCLUSION: Ilizarov external fixation facilitates earlier partial and full weight-bearing compared to internal fixation, with similar healing times and functional outcomes, suggesting its efficacy as an alternative to internal fixation for complex tibial plateau fractures.

PMID:41191069 | DOI:10.1007/s00264-025-06679-x

Int Orthop. 2025 Nov 5. doi: 10.1007/s00264-025-06690-2. Online ahead of print.

ABSTRACT

INTRODUCTION: Medical registries are structured tools for collecting, monitoring, and analyzing clinical data for epidemiological purposes, as well as for improving patient care. In the field of orthopaedics, arthroplasty registries help monitor implant performance, identify complications, and standardize surgical practices. In Burkina Faso, despite the increase in the number of joint replacements and epidemiological features such as sickle cell disease, no national registry exists. This work aims to establish a prototype of a registry tailored to local realities.

METHODS: A cross-sectional descriptive study was conducted, combining a literature review to assess the existing situation and a questionnaire survey administered to orthopaedic surgeons in Burkina Faso. The analysis was conducted with Python 3.12.3, integrating descriptive statistics, visualizations, and synthesis of functional expectations.

RESULTS: To date, there is no structured system for monitoring orthopaedic implantable devices at the national level. Orthopedists during the survey expressed the need for a centralized, secure, and accessible system, allowing the traceability of implants, the monitoring of complications, and the production of reports that can guide the choice of prostheses. Priority features include web and smartphone access, prosthesis survival statistics, and implant selection recommendations. The main constraints identified are the lack of a homogeneous IT infrastructure and limited financial resources. Based on the needs collected, a prototype was modeled, including UML diagrams, specifications, and web and smartphone models.

CONCLUSION: The establishment of a national arthroplasty registry is perceived as a strategic lever by practitioners to improve the quality of care and strengthen the surveillance of implantable devices. The prototype is intended to be a contextual, secure, and scalable solution. A pilot phase is recommended, with strong institutional support (Ministry of Health, National Orthopedics society) and participatory governance to ensure user buy-in and the sustainability of the registry.

PMID:41191068 | DOI:10.1007/s00264-025-06690-2

Injury. 2025 Oct 28:112851. doi: 10.1016/j.injury.2025.112851. Online ahead of print.

NO ABSTRACT

PMID:41193329 | DOI:10.1016/j.injury.2025.112851

Injury. 2025 Oct 31;56(12):112860. doi: 10.1016/j.injury.2025.112860. Online ahead of print.

ABSTRACT

OBJECTIVES: Open ankle fractures in the geriatric population display poor outcomes. However, limited data exists comparing operative outcomes between open and closed geriatric ankle fractures. Our purpose was to investigate differences in perioperative complications and mortality among open and closed ankle fractures in geriatric patients.

METHODS: The TriNetX US Collaborative Network database was queried to identify patients aged 65 and older who experienced operatively treated, isolated open or closed ankle fractures between 2014 and 2024. Patients were divided into two propensity-matched cohorts depending on open vs closed injuries. Rates of complications and mortality were compared between operatively treated open and closed ankle fractures in geriatric patients.

RESULTS: Overall, 27,860 patients met inclusion criteria. Of these, 25,257 (90.7 %) sustained closed ankle fractures and 2603 (9.3 %) sustained open ankle fractures. After 1:1 propensity matching, each cohort included 2565 patients. At early time points (<30 days), DVT, MI, sepsis, pneumonia, AKI, ABLA, opioid use, deep infection, ED visits and rehospitalizations were higher in open ankle fractures (p < 0.05). At delayed time points from 90 days to 1 year, DVT, pneumonia, ARDS, AKI, ABLA, SSI, deep infection, sepsis, BKA, emergency department visits, rehospitalizations and death remained significantly higher in open ankle fractures (p < 0.05). Notably, open ankle fractures had significantly increased rates of mortality at 90 days (p = 0.007), 180 days (p = 0.004), and 1 year (p < 0.0001). At 1 year, bimalleolar and trimalleolar open ankle fractures also demonstrated significantly higher mortality rates (p < 0.05).

CONCLUSIONS: Open geriatric ankle fractures, irrespective of fracture morphology, demonstrate significantly higher rates of mortality and postoperative complications including DVT, MI, pneumonia, AKI, sepsis, SSI, deep infections, BKA, emergency department visits and rehospitalizations. Our findings suggest the need for enhanced perioperative counseling and preventative strategies to address modifiable risk factors in geriatric orthopaedic patients undergoing operative fixation for open ankle fractures.

LEVEL OF EVIDENCE: retrospective cohort study, level of evidence III.

PMID:41192085 | DOI:10.1016/j.injury.2025.112860

J Bone Joint Surg Am. 2025 Nov 5;107(21):e99. doi: 10.2106/JBJS.25.01006. Epub 2025 Nov 5.

NO ABSTRACT

PMID:41190999 | DOI:10.2106/JBJS.25.01006