Automated diagnosis and classification of metacarpal and phalangeal fractures using a convolutional neural network: a retrospective data analysis study.

Background And Purpose:  Hand fractures are commonly presented in emergency departments, yet diagnostic errors persist, leading to potential complications. The use of artificial intelligence (AI) in fracture detection has shown promise, but research focusing on hand metacarpal and phalangeal fractures remains limited. We aimed to train and evaluate a convolutional neural network (CNN) model to diagnose metacarpal and phalangeal fractures using plain radiographs according to the AO/OTA classification system and custom classifiers.

Polyunsaturated fatty acids suppress PIEZO ion channel mechanotransduction in articular chondrocytes.

Osteoarthritis (OA) is characterized by articular cartilage degeneration, leading to pain and loss of joint function. Recent studies have demonstrated that omega-3 (ω3) polyunsaturated fatty acid (PUFA) supplementation can decrease injury-induced OA progression in mice fed a high-fat diet. Furthermore, PUFAs have been shown to influence the mechanical properties of chondrocyte membranes, suggesting that alterations in mechanosensitive ion channel signaling could contribute to the mechanism by which ω3 PUFAs decreased OA pathogenesis.

Malpractice Liability Exposure and the Sports Medicine Team Physician: Caring for Professional Athletes in the National Football League, Major League Baseball, and National Hockey League.

Background: Orthopaedic surgeons play a critical role in ensuring the health and safety of professional athletes. Despite the privilege of treating elite athletes, there exists great financial exposure to individual physicians in the event of a malpractice lawsuit.

Hypothesis/purpose: The purpose of this study was to evaluate and model malpractice liability exposure of the sports medicine surgeon caring for athletes in the National Football League (NFL), Major League Baseball (MLB), and National Hockey League (NHL) with respect to player position and additional supplemental malpractice insurance needs.

Podiatric Clinical Triage in a Foot and Ankle Orthopaedic Clinic: A Randomised Trial.

Rationale: Hospitals are increasingly utilising allied-health professionals to provide clinical triage to patients. While these positions are routinely implemented, and several observational studies have reported positive outcomes, the effectiveness of this intervention has been rarely tested in a clinical trial.

Aims And Objectives: The objectives of this study were to (i) evaluate a podiatry-led orthopaedic triage service using patient-reported outcome measures (PROMs), and (ii) determine if it is cost-effective in terms of incremental cost/quality-adjusted life years (QALYs).

Integrating D-Dimer Thresholds into the Revised Caprini Risk Stratification to Predict Deep Vein Thrombosis Risk in Preoperative Knee Osteoarthritis Patients.

Introduction: Preoperative patients with knee osteoarthritis have a significantly increased risk of venous thromboembolism (VTE). While the Caprini risk assessment model offers some clinical guidance in predicting deep vein thrombosis (DVT), it has a relatively low predictive accuracy. Enhancing the model by integrating biomarkers, such as D-dimers, can potentially improve its accuracy.

Randomized Controlled Trial to Compare AmnioExcel Human Amniotic Allograft in Weekly Versus Biweekly Treatment of Diabetic Foot Ulcers.

Our objective was to compare clinical outcomes in diabetic foot ulcers (DFU) treated with AmnioExcel applied weekly (AMX1) or biweekly (AMX2) over a 12-week evaluation period. This randomized clinical trial evaluated 40 people with UT 1A and 1D DFUs >30 days but less than 6 months duration and age >21 years. We excluded patients with untreated osteomyelitis, gangrene, widespread malignancy, or active substance abuse.

Short-term outcomes of gradual ulnar lengthening in multiple hereditary osteochondromas of the forearm with monolateral external fixator.

Hereditary multiple exostoses is an autosomal dominant genetic condition primarily affecting long bones. Forearm deformities, including wrist ulnar deviation, ulnar shortening, radial or ulnar bowing, and radial head dislocation, are common manifestations. Gradual ulnar lengthening is suggested as a viable treatment option for managing these deformities.

The Effect of Expressive Writing on the Experiences of Head and Neck Cancer Patients Undergoing Radiotherapy: A Randomized Controlled Trial.

Background: Expressive writing (EW) has emerged as an innovative strategy for improving mood and quality of life. Nevertheless, insufficient research has been conducted on the impact of offering EW to patients with HNC. Therefore, the purpose of this study was to investigate the effects of two forms of EW on anxiety, depression, nutrition, and sleep quality in HNC patients undergoing radiotherapy.

Intramalleolar triplane ankle fractures in adolescents.

This article aims to describe a multicenter cohort of atypical triplane ankle fractures with intramalleolar involvement of the epiphysis, providing insights into the affected population, treatment outcomes, and complications. In addition, we propose a treatment strategy for such fractures based on our findings. A retrospective analysis was conducted on adolescent patients diagnosed with triplane ankle fractures.

Was the ultrasound examination for developmental dysplasia of the hip performed correctly? Introduction of a rapid training tool for nonexpert practitioners.

Pediatricians and general practitioners are involved in the newborn screening for developmental dysplasia of the hip. They often rely on the quality of the ultrasound (US) examination to make diagnostic and therapeutic decisions. Therefore, the professional must be able to assess its quality.

Factors influencing recurrence in clubfoot treatment with the Ponseti method in children under 5 years of age: a scoping review.

Clubfoot (CF) is one of the most common musculoskeletal congenital abnormalities. Despite having optimal methods for its treatment, factors associated with the recurrence of CF treatment continue to be a topic of interest. The aim of this study was to perform a scoping review of the existing literature on factors associated with the recurrence of CF following treatment with the Ponseti method in children under 5 years of age.

Is percutaneous heel cord tenotomy a necessary component in the Ponseti treatment of idiopathic clubfoot deformity?

This study aimed to compare outcomes of idiopathic clubfeet (IC) treated with a percutaneous heel cord tenotomy (PHCT) at the conclusion of Ponseti casting with those that were not. A retrospective review of patients enrolled in a single institution prospective clubfoot registry over 19 years was performed. Patients under the age of 3 months with untreated IC managed via the Ponseti method that had a minimum of 2 years follow-up were included.

Evaluating the quality of life in mothers caring for children with congenital clubfoot: prospective sequential evaluation along the course of Ponseti management.

The post birth revelation of child with physical anomaly taxes maternal hopes of a healthy child. However, unlike many other congenital anomalies, the Ponseti method has enabled an early and effective treatment of the clubfoot deformity. Our study aimed to assess the quality of life (QoL) of mothers with child born with idiopathic clubfoot through various stages of its management compared to a healthy infant.

Single-Cell Multi-omics Assessment of Spinal Cord Injury Blocking via Cerium-doped Upconversion Antioxidant Nanoenzymes.

Spinal cord injury (SCI) impairs the central nervous system and induces the myelin-sheath-deterioration because of reactive oxygen species (ROS), further hindering the recovery of function. Herein, the simultaneously emergency treatment and dynamic luminescence severity assessment (SETLSA) strategy is designed for SCI based on cerium (Ce)-doped upconversion antioxidant nanoenzymes (Ce@UCNP-BCH). Ce@UCNP-BCH can not only efficiently eliminate the SCI localized ROS, but dynamically monitor the oxidative state in the SCI repair process using a ratiometric luminescence signal.

Multidisciplinary Oral Rehabilitation of Complex Frontonasal Dysplasia: A Case Report.

This case report presents the multidisciplinary treatment of a male patient with a complex form of frontonasal dysplasia who presented with a 0 to 14 facial cleft, mild hypertelorism, absence of the nasal medial process of the nose, and frontonasal encephalocele. Cranial and plastic surgeries were performed to correct hypertelorism and improve the esthetic appearance of the frontonasal region. In the permanent dentition, the patient presented a Class II, division 1 malocclusion with severe maxillary constriction and bilateral posterior crossbite.

Dementia Care Research and Psychosocial Factors.

Background: Care partners of hospitalized people living with dementia (PLWD) are particularly vulnerable in the hospital setting and may feel invisible during hospitalization of the PLWD they care for. Hospital initiatives for dementia friendly spaces emphasize providing a safe and supportive environment. However, literature is scarce regarding how the hospital's physical environment influences care partners' inclusion.

Kinesophobia in patients with osteoporotic vertebral compression fractures: a latent profile analysis.

Objective: To explore the status of kinesophobia in patients with osteoporotic vertebral compression fractures and analyze the influencing factors of different kinesophobia profiles.

Design: Cross-sectional survey study.

Participants: A total of 245 patients with osteoporotic vertebral compression fractures who underwent surgical treatment at our Department of Orthopedics between January 2023 and March 2024 were selected.

Comparison of individually packed metalwork and on-the-tray metalwork: A review of clinical risks.

The use of metalwork, such as screws and plates, is common in orthopaedic trauma surgery, with a recent trend towards individually packed metalwork owing to concerns about sterilization efficacy and traceability. Despite this, there is no clinical evidence proving clinical risk from repeat sterilization of metalworks used in orthopaedic trauma of either increased infection rates or loosening or implant failure. On the contrary, the use of individually packed metalworks presents several practical challenges, including higher costs, increased risks of contamination, longer operative times and a larger carbon footprint.

Effectiveness of adjuvant leukocyte-poor platelet-rich plasma in carpal tunnel release: a randomized controlled trial.

This study assessed the effectiveness of adding leukocyte-poor platelet-rich plasma (PRP) during carpal tunnel release surgery for patients with moderate to severe carpal tunnel syndrome. In a randomized controlled trial, 70 patients were assigned to either standard carpal tunnel release (control group) or release with leukocyte-poor PRP applied to the median nerve (PRP group). Primary outcomes were measured using the Boston Carpal Tunnel Questionnaire at 3 months, and secondary outcomes included pain, strength, sensation and electrodiagnostic examinations at multiple time points.

Treatment of anterior rim fractures of the distal radius with an anterior rim plate: A retrospective study.

Treatment of distal radial fractures that include small anterior rim fragments can be difficult. We retrospectively reviewed 19 patients in whom an anterior rim plate with locking screws was used. After a median follow-up of 18 months (range 6-32; interquartile range (IQR) 14, 26), the median wrist flexion and extension arc was 70° (range 50-80; IQR 60, 70), the median grip strength was 80% of the contralateral side (range 52-104; IQR 77, 88), the median visual analogue scale score for pain was 0 (range 0-5; IQR 0, 1), the median disabilities of the arm, shoulder and hand score was 2 (range 0-59; IQR 0, 11) and the median modified Mayo wrist score was 80 (range 35-100; IQR 75, 85).

Triple nerve transfer for restoration of elbow flexion in C5-C6 traumatic brachial plexus injuries.

We retrospectively reviewed the outcome of triple nerve transfer, including reinnervation of brachioradialis and double nerve transfer surgery in C5-C6 traumatic brachial plexus injuries. IV.

Surgical outcomes of radial polydactyly according to a modified Wassel-Flatt classification: A retrospective study of 211 patients with 223 thumbs.

We previously introduced the modified Wassel-Flatt classification to overcome the limitation of the traditional classification for radial polydactyly. This study aimed to evaluate this modified classification in terms of surgical planning and clinical outcomes using the Japanese Society for Surgery of the Hand scoring system. A retrospective review of 211 patients with 223 thumbs treated for radial polydactyly between October 2017 and November 2022 was conducted.

The forced small finger abduction test for assessing the strength of intrinsic muscles innervated by the ulnar nerve.

The study evaluates the forced small finger abduction test for assessing the strength of intrinsic muscles innervated by the ulnar nerve. The test was performed on healthy and ulnar neuropathy patients. Results demonstrate its ability to detect intrinsic weakness, which may enhance diagnosis of ulnar neuropathy.

Evaluation of the Diagnostic Accuracy of Percutaneous Core Needle Biopsy in Bone and Soft Tissue Tumors.

Purpose Of The Study: Open (incisional) biopsies have long been accepted as the gold standard in diagnosing bone and soft tissue tumors. However, the main disadvantage of this method is that it can lead to increased contamination, hematoma, infection, and pathological fracture. Compared to open biopsies, percutaneous core needle biopsies are less invasive, do not require hospitalization, have low costs and low complication rates, and there is no need for wound healing in cases that require radiotherapy.