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J Shoulder Elbow Surg 2022 Mar 9. Epub 2022 Mar 9.

Orthopedic Trauma Department, Alrazi Orthopedic Hospital, Kuwait. Electronic address:

Background: The development of radioulnar synostosis secondary to posttraumatic injuries to the elbow or forearm can lead to debilitating outcomes. Several treatment options are available to hinder the progression and prevent reoccurrence. The authors used a combination of these treatments on a series of patients and observed the outcomes. Read More

Clin Orthop Relat Res 2022 Mar 10. Epub 2022 Mar 10.

Department of Orthopedics, E-Da Hospital, Kaohsiung, Taiwan.

Background: The treatment of complex persistent elbow instability after trauma is challenging. Previous studies on treatments have reported varied surgical techniques, which makes it difficult to establish a therapeutic algorithm. Furthermore, the surgical procedures may not sufficiently restore elbow stability, even with an additional device, and a noted high rate of arthritis progression. Read More

OTA Int 2022 Mar 28;5(1):e173. Epub 2022 Feb 28.

MetroHealth Medical Center, Cleveland, Ohio, affiliated with Case Western Reserve University.

Objectives: The purposes of this project were to evaluate functional outcomes more than 5 years after acetabulum fracture and to determine factors related to function.

Methods: This retrospective study consisted of 205 adult patients treated for acetabulum fracture who completed the Musculoskeletal Function Assessment (MFA) a minimum of 5 years following injury. The MFA includes survey of daily activities, gross and fine mobility, social and work function, sleeping, and mood. Read More

Cureus 2022 Jan 10;14(1):e21094. Epub 2022 Jan 10.

Orthopaedic Department, Medical School, University of Patras, Patras, GRC.

Introduction Treatment of intra-articular fractures of the distal humerus is challenging due to their complexity, comminution, and associated complications. The evolution of surgical approaches and the design of elbow-specific implants over the last decades have failed to improve clinical and radiological outcomes. Studies are sparse regarding the long-term influence of surgical treatment of these types of fractures in the upper limb function. Read More

Unfallchirurg 2022 Jan 25. Epub 2022 Jan 25.

Klinik für Orthopädie, Unfallchirurgie und Sporttraumatologie, Marienhospital Stuttgart, Böheimstr. 37, 70199, Stuttgart, Deutschland.

Background: Radial head arthroplasty is recognized as the gold standard in the treatment of patients with unreconstructable radial head fractures.

Objective: The aim of this retrospective study was to investigate the long-term results after prosthetic replacement of the radial head and in a subgroup analysis to identify factors which influence the outcome.

Material And Methods: A total of 48 patients with unreconstructable fractures of the radial head and neck were treated by cementless radial head arthroplasty between 05/2008 and 10/2018 (30 bipolar prosthesis type rHead Recon, 18 monopolar prosthesis type MoPyc). Read More

J Shoulder Elbow Surg 2022 Mar 27;31(3):469-480. Epub 2021 Dec 27.

Department of Orthopedics, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China; Shanghai Engineering Research Center for Orthopedic Material Innovation and Tissue Regeneration, Shanghai, China. Electronic address:

Background: Joint stiffness is a common complication after articular-related trauma in the elbow, resulting in significant limb disability, psychological stress, and a negative impact on daily life. No previous study has reported the impact of post-traumatic elbow stiffness (PTES) on psychological health. This study aims to (1) investigate the depression and anxiety levels and (2) identify factors independently associated with depression and anxiety symptoms in patients with PTES. Read More

J Healthc Eng 2021 7;2021:4066415. Epub 2021 Dec 7.

Department of Traumatology Acupuncture and Massage, Sixth People's Hospital Affiliated to Shanghai Jiaotong University, Shanghai 200233, China.

This article conducts a retrospective analysis of 500 patients with posttraumatic elbow dysfunction admitted to our department from March 2019 to September 2020. The average time from injury to operation is 11 months (2-20 months). We adopt a personalized treatment method to completely remove the hyperplastic adhesion tissue and heterotopic ossification around the joint, remove part of the joint capsule and ligament, and release it to achieve maximum function. Read More

EFORT Open Rev 2021 Nov 19;6(11):1122-1131. Epub 2021 Nov 19.

Department of Trauma and Reconstructive Surgery, Eberhard Karls University Tuebingen, BG Trauma Center Tuebingen, Germany.

Fractures of the femoral head are rare injuries, which typically occur after posterior hip dislocation.The Pipkin classification, developed in 1957, is the most commonly used classification scheme to date.The injury is mostly caused by high-energy trauma, such as motor vehicle accidents or falls from a significant height. Read More

World J Orthop 2021 Aug 18;12(8):604-619. Epub 2021 Aug 18.

Department of Orthopaedic, Assiut University Hospital, Assiut 71515, Egypt.

Background: Femoral head fractures (FHFs) are considered relatively uncommon injuries; however, open reduction and internal fixation is preferred for most displaced fractures. Several surgical approaches had been utilized with controversial results; surgical hip dislocation (SHD) is among these approaches, with the reputation of being demanding and leading to higher complication rates.

Aim: To determine the efficacy and safety of SHD in managing FHFs by reviewing the results reported in the literature. Read More

J Am Acad Orthop Surg 2021 Nov;29(21):e1057-e1067

From the Department of Orthopaedic Surgery (Perdue, Toney), Christiana Hospital, Newark, DE (Tainter) Virginia Commonwealth University, Richmond, VA, and the Department of Orthopaedic Surgery (Lee), University of California, Los Angeles, Los Angeles, CA.

Posterior wall acetabulum fractures typically result from high-energy mechanisms and can be associated with various orthopaedic and nonorthopaedic injuries. They range from isolated simple patterns to multifragmentary with or without marginal impaction. Determination of hip stability, which can depend on fragment location, size, and displacement, directs management. Read More

Indian J Orthop 2021 Aug 25;55(4):898-906. Epub 2021 Feb 25.

Orthopaedics and Spine Surgery, Ganga Hospital, Coimbatore, India.

Background: Open excision remains the gold standard of treatment for posttraumatic heterotopic ossification (HO) of the elbow. The purpose of this study is to evaluate the functional outcome of early surgical excision done by adhering to a proposed surgical protocol with exclusive posttraumatic HO of the elbow.

Methods: A retrospective study was conducted with 31 patients (25 males and 6 females) with a mean follow-up of 40. Read More

Arthritis Rheumatol 2021 12 28;73(12):2249-2260. Epub 2021 Oct 28.

Washington University, St. Louis, Missouri.

Objective: Recent evidence delineates an emerging role of periostin in osteoarthritis (OA), since its expression after knee injury is detrimental to the articular cartilage. We undertook this study to examine whether intraarticular (IA) knockdown of periostin would ameliorate posttraumatic OA in a murine model.

Methods: Posttraumatic OA was induced in 10-week-old male C57BL/6J mice (n = 24) by destabilization of the medial meniscus (DMM), and mice were analyzed 8 weeks after surgery. Read More

Front Cell Dev Biol 2021 11;9:629274. Epub 2021 Feb 11.

Department of Orthopedics, The Third Affiliated Hospital, Southern Medical University, Guangzhou, China.

Although heterotopic ossification (HO) has been reported to be a common complication of the posttraumatic healing process, the underlying mechanism remains unknown. Endothelial-mesenchymal transition (EndMT) is known to play a role in HO, and our recent study observed that neuroendocrine signals can promote HO by modulating EndMT. Melatonin, a neuroendocrine hormone secreted mainly by the pineal gland, has been documented to perform its function in the skeletal system. Read More

J Pediatr Orthop 2021 Mar;41(3):e266-e271

Department of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital.

Background: Open arthrolysis is used for treating elbow stiffness in adults. This study evaluated the midterm outcomes after open arthrolysis in children and adolescents with posttraumatic elbow stiffness.

Methods: Data of 31 children and adolescents with posttraumatic elbow stiffness following open arthrolysis with or without hinged external fixation from 2010 to 2014 were retrospectively analyzed. Read More

Orthop Surg 2020 Oct;12(5):1471-1477

Department of Hand Surgery, Huashan Hospital, Fudan University, Shanghai, China.

Objectives: To evaluate the incidence and risk factors of heterotopic ossification (HO) after arthroscopic elbow release.

Methods: The present study included 101 elbows, with arthroscopic release performed on 98 patients over the 5-year period from November 2011 to December 2015. Patients were divided into three groups: group 1, with elbow arthritis, including 46 elbows in 43 patients; group 2, with posttraumatic extrinsic elbow stiffness (without intraarticular adhesion), including 23 elbows in 23 patients; and group 3, with intrinsic contractures (with intraarticular adhesion), including 32 elbows in 32 patients. Read More

Knee Surg Sports Traumatol Arthrosc 2021 Sep 31;29(9):3037-3048. Epub 2020 Oct 31.

Department of Orthopaedic Surgery, Medical School, Democritus University of Thrace, University General Hospital of Alexandroupolis, 68100, Alexandroupolis, Greece.

Purpose: The purpose of this study was to systematically review case reports and case series about meniscal ossicle, to summarize existing evidence. Specifically, to identify the etiology, demographic characteristics, localization, clinical features, diagnostic procedures and treatment options of this rare entity. Although, case reports/ series are of low level of evidence, a systematic review of such studies can provide and help us to gain a better understanding and awareness of meniscal ossicle. Read More

Orthop Surg 2020 Oct 4;12(5):1464-1470. Epub 2020 Oct 4.

Department of Hand Surgery, Huashan Hospital, Fudan University, Shanghai, China.

Objectives: To evaluate the effectiveness of arthroscopic management of posttraumatic elbow stiffness due to soft tissue problems.

Methods: A retrospective review of 30 consecutive arthroscopic elbow releases for posttraumatic stiff elbow from November 2011 to December 2019 was conducted. Stiff elbows with bony problems, such as heterotopic ossification, intraarticular nonunion or malunion, and cartilage lesions were excluded from this study. Read More

J Bone Joint Surg Am 2020 Nov;102(21):1891-1899

Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, Maryland.

Background: Heterotopic ossification (HO) is characterized by the abnormal growth of ectopic bone in soft tissues, frequently occurring within the military population because of extensive orthopaedic combat trauma. MicroRNAs (miRNAs) are small noncoding RNAs that act as post-transcriptional regulators of gene expression. We hypothesized that a clinically relevant miRNA signature could be detected in patients following injury that progressed to form HO (HO+) or did not form HO (HO-). Read More

J Pediatr Orthop 2020 Oct;40(9):e839-e843

Department of Orthopaedic Surgery, Stanford University School of Medicine, Packard Children's Hospital at Stanford, Stanford, CA.

Background: A subfibular ossicle (SO), also known as an os subfibulare, is present in ∼1% of the general population. Two theories have been proposed to explain the origin of SOs: (1) as a failure of fusion of a secondary center of ossification; (2) as a posttraumatic sequela. This report offers prospective, longitudinal radiographic evidence for the formation of SOs as a posttraumatic sequela of type VII transepiphyseal fractures of the lateral malleolus in children. Read More

J Am Acad Orthop Surg 2021 Feb;29(4):e178-e187

From the Department of Orthopedic Surgery, NYU Langone Orthopedic Hospital, New York, NY.

Purpose: The ability to predict contracture development after elbow fracture would benefit patients and physicians. This study aimed to identify factors associated with the development of posttraumatic elbow joint contracture.

Methods: A retrospective review of elbow fractures (AO/Orthopaedic Trauma Association [OTA] type 13 and 21) treated at one institution between 2011 and 2015 was performed. Read More

Case Rep Orthop 2019 23;2019:3526018. Epub 2019 Oct 23.

Hip and Pelvis Unit, Orthopedic Department, University Hospital of Santa Maria, Avenida Professor Egas Moniz, 1649-035 Lisbon, Portugal.

Introduction: Pipkin fractures are rare events and usually occur as a consequence for high-energy trauma. Surgery to obtain anatomical reduction and fixation is the mainstay treatment for the majority of these injuries; nonetheless, controversy exists regarding the best surgical approach.

Description Of The Case: We present the case of a 41-year-old male, which sustained a type II Pipkin fracture following a motorcycle accident. Read More

Oper Orthop Traumatol 2020 Jun 13;32(3):248-261. Epub 2019 Nov 13.

Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Bonn, Venusberg-Campus 1, 53127, Bonn, Deutschland.

Objective: Optimal reconstruction of acetabular anatomy and primarily stable bridging even of large bone defects in hip revision surgery by intraoperative cementless application of highly modular components of the MRS-TITAN Comfort (MRS-C) system according to the augment-and-modular-cage principle.

Indications: Acetabular defect situations in hip revision surgery, hereditary/acquired acetabular deformities, severe secondary hip osteoarthritis.

Contraindications: Extended periacetabular defects of the dorsal pillar, pelvic discontinuities, persisting posttraumatic or periprosthetic infections, lack of intraoperative bony anchorage options. Read More

Arch Orthop Trauma Surg 2020 Mar 9;140(3):331-341. Epub 2019 Sep 9.

BG Trauma Center Tübingen, Eberhard Karls University of Tübingen, Schnarrenbergstr. 95, Tübingen, Germany.

Background: Total hip arthroplasty (THA) is a challenging option for the treatment of posttraumatic arthritis due to acetabular fractures.

Methods: The study aimed to determine the short- and mid-term clinical and radiographic results of THA following acetabular fracture. The fracture pattern, the extent of injury and the initial fracture treatment were considered to evaluate the influence of these factors on the clinical-radiographic outcome. Read More

Arch Orthop Trauma Surg 2019 Dec 5;139(12):1723-1729. Epub 2019 Aug 5.

Department of Trauma, Hand and Reconstructive Surgery, University Hospital Münster, Albert-Schweitzer-Campus, Building W1, 48149, Munster, Germany.

Introduction: Complex radial head fractures are difficult to treat. In cases where stable fixation cannot be achieved, radial head resection or primary arthroplasty are frequently performed. Ex situ reconstruction of comminuted fractures may also be an option. Read More

Arch Orthop Trauma Surg 2019 Nov 8;139(11):1587-1597. Epub 2019 Jul 8.

Department of Orthopedic Surgery, Korea University Guro Hospital, Seoul, South Korea.

Purpose: The purposes of the study were to introduce surgical technique of fragment-specific fixation technique using multiple 2.7-mm variable-angle locking compression plates (VA LCPs) in comminuted posterior wall acetabular fractures and reported its clinical results.

Patients And Methods: Among the 68 patients, 23 with comminuted posterior wall factures with ≥ 3 fragments in the CT scan and no column involvement with a minimum follow-up duration of 12 months were enrolled in this study. Read More

Clin Orthop Relat Res 2019 Oct;477(10):2319-2328

Z. Sun, H. Cui, J. Ruan, J. Li, W. Wang, C. Fan, Department of Orthopedics, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, P. R. China W. Wang, C. Fan, Department of Orthopedics, Shanghai Sixth People's Hospital East Affiliated to Shanghai University of Medicine & Health Sciences, Shanghai, P. R. China.

Background: The elbow is more susceptible to loss of motion after trauma than any other joint. Open arthrolysis often is performed for posttraumatic elbow stiffness if the stiffness does not improve with nonsurgical treatment, but the midterm results of this procedure and factors that may limit recovery have not been widely studied.

Questions/purposes: We reviewed patients who had undergone open arthrolysis with hinged external fixator for severe posttraumatic elbow stiffness (ROM ≤ 60°) with a minimum of 5 years followup to (1) analyze ROM gains; (2) assess functional improvement with the Mayo Elbow Performance Index (MEPI) and DASH, quality of life with the SF-36, pain with VAS, and ulnar nerve function with the Amadio rating scale and Dellon classification; and (3) identify complications and risk factors that might hinder mid-term elbow motion recovery after this procedure. Read More

Technol Health Care 2019 ;27(4):431-439

Department of Orthopedics and Trauma Surgery, St. Josef-Hospital Bochum, Katholisches Klinikum Bochum, Ruhr University Bochum, Bochum, Germany.

Background: Treatment of distal intra-articular humerus fractures is still a technical challenge. Until now, little is known about the regain of strength and elbow agility after surgical treatment of these fractures. Due to small collectives there is only limited data. Read More

Orthop Res Rev 2019 4;11:41-46. Epub 2019 Feb 4.

Faculty of Medicine, Guilan University of Medical Sciences, Rasht, Iran,

Background: Fractures of the acetabulum are challenging and very difficult to treat, and even after fixation, they can lead to posttraumatic arthritis. Total hip arthroplasty (THA) has been the most common surgery performed for the complications of posttraumatic arthritis in this group of patients.

Aim: In this article, it is aimed to assess the functional results and complications of the conversion to THA for posttraumatic arthritis after acetabular fracture. Read More

J Neurosurg Spine 2018 12;30(3):362-366

The authors report on the first surgical treatment for traumatic interspinous ligament calcification, with significant radiographic and symptomatic improvements at long-term follow-up. Heterotopic ossification occurs following traumatic injury but does not typically affect the interspinous ligaments. While these ligaments can calcify with age, this is rarely seen in patients younger than 50 years of age. Read More

J Bone Joint Surg Am 2018 Dec;100(23):2066-2072

Department of Orthopedic Surgery, Gumi CHA University Hospital, Gumi, South Korea.

Background: Although simple posterolateral or posterior elbow dislocations are relatively common and usually stable after closed reduction, simple posteromedial dislocations are extremely rare and poorly characterized. We investigated the clinical characteristics, soft-tissue injury patterns, treatments, and outcomes of a series of posteromedial elbow dislocations without relevant osseous lesions.

Methods: We retrospectively reviewed 20 cases of simple posteromedial elbow dislocations without relevant osseous lesions that were treated at 7 fellowship training hospitals during a 10-year period. Read More