Physical impairment as the dominant component of new-onset post-intensive care syndrome following in-hospital resuscitation.

A Systematic Review of Patient-Reported Outcomes on the Impact of Radiation Therapy on Sexual Health in Patients With Gynecologic Cancer.

Temporal changes in quadriceps and hamstring strength and flexibility following total knee arthroplasty.

The role of sex and age in response to early post-myocardial infarction cardiac rehabilitation.

Age-related hearing loss (ARHL) or presbycusis is a bilateral sensorineural hearing impairment associated with aging of the structures of the inner ear and auditory pathways and is the most common cause of acquired hearing loss in older adults. Presbycusis is a disabling condition that affects communication and quality of life, and has been associated with poorer cognitive performance. This study aimed to examine the association between ARHL, cognitive screening performance, and hearing-related quality of life in older adults. This single-center prospective observational study with cross-sectional analysis included 60 participants aged 60 years and older: 40 patients with presbycusis and 20 control participants with normal hearing or mild hearing loss. Hearing threshold was examined using pure-tone audiometry and expressed as the Pure Tone Average (PTA). Cognitive function was screened using the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA), and quality of life was evaluated using the Hearing Handicap Inventory for the Elderly Screening Version (HHIE-S) questionnaire. On cognitive screening, most patients with age-related hearing loss scored in the range suggestive of cognitive impairment, and 90% reported reduced hearing-related quality of life. Statistically significant correlations were observed between PTA and both MoCA and MMSE scores, suggesting that hearing threshold is strongly associated with cognitive status. Exploratory analyses also suggested an association between self-reported duration of hearing loss and cognitive screening results, although this finding should be interpreted cautiously. In this sample of older adults, worse hearing thresholds were associated with poorer performance on cognitive screening instruments and with lower hearing-related quality of life. These findings support further investigation of early hearing assessment and rehabilitation in older adults, and indicate the necessity of effective and timely auditory amplification, even in individuals with moderate hearing loss.

The number of kidney transplant recipients over the age of 70 is increasing. These older patients are at higher risk of malnutrition, yet data on their post-transplant nutritional status are scarce. This was a single-center retrospective pilot study conducted at Caen University Hospital. It included kidney transplant recipients aged over 70years. The objective was to assess weight change between transplant notification and the first month post-transplant. In our study, 31 of 71patients (44%) experienced weight loss ≥5% at one month (M1). Few pre-transplant factors were associated with malnutrition risk. However, weight loss during the first postoperative week was a significant predictive factor (OR: 1.82; 95% CI: 1.35–2.73; p=0.001). Malnutrition is an early post-transplant complication and is frequent at one month (M1) in older patients. Early prehabilitation and rehabilitation programs implemented by multidisciplinary teams (nephrologists, advanced practice nurses, dieticians, geriatricians, physiotherapists, psychologists, etc.) are essential.

Cerebral palsy (CP) is one of the most common childhood neurodisability globally and disproportionately affects children in low- and middle-income countries. In Cameroon, limited epidemiological data, weak rehabilitation infrastructure, and entrenched sociocultural beliefs shape how CP is understood and managed. Children with CP often require lifelong support, placing substantial physical, emotional, and economic demands on family-caregivers, most commonly mothers. Understanding caregivers' lived experiences within specific cultural and resource-limited contexts is critical for informing inclusive and effective interventions. This study explored the lived experiences and challenges of family-caregivers of children with CP in Magba Subdivision, West Region of Cameroon. This study employed a qualitative exploratory design using in-depth interviews and inductive content analysis. Participants were family caregivers of children with CP, purposively recruited through community-based rehabilitation (CBR) services. In-depth, face-to-face interviews were conducted in English or local languages, audio-recorded, transcribed, and translated. Data were analysed using inductive content analysis following Elo and Kyngäs' approach. Findings were interpreted using Raina et al.'s multidimensional caregiving model. All participants, aged 15-49 years, were family caregivers of children with CP, aged 4-15 years. Six interrelated themes emerged: (1) sociocultural challenges, including stigma, discrimination, and harmful spiritual beliefs framing CP as witchcraft, ancestral punishment, 'snake', or 'marine spirit'; (2) economic constraints arising from inability to engage in paid work and the absence of social protections; (3) physical caregiving burden characterised by exhaustion, chronic pain, and musculoskeletal strain; (4) inadequate specialized services and health information; (5) limited social/family support; and (6) limited access rehabilitation services. These challenges intensified caregiver isolation and emotional distress. Caregiving for children with CP in Magba is shaped by intersecting sociocultural, economic, and systemic factors that extend beyond individual coping capacity. Strengthening culturally sensitive community-based rehabilitation, improving access to early diagnosis and rehabilitation, and implementing disability- and gender-responsive social protection policies are essential to reduce caregiver burden and promote inclusive child and family wellbeing in Cameroon.

BACKGROUND Total knee arthroplasty (TKA) is increasingly performed in older patients to manage severe osteoarthritis. Given the aging population, optimizing surgical techniques for this age group has become increasingly important. The surgical approach impacts postoperative outcomes, particularly in patients aged 75 years and over, who are prone to immobilization-related complications. This study compared the subvastus (SV) and medial parapatellar (MP) approaches, focusing on rehabilitation, early mobilization, and complications. MATERIAL AND METHODS A retrospective trial included 60 patients aged over 75 years with stage IV osteoarthritis, undergoing TKA. Patients were divided into SV or MP approaches. Outcomes included time to straight leg raise (SLR), range of motion (ROM), pain (visual analog scale, VAS), length of hospital stay, and complications. RESULTS The SV group achieved earlier SLR (1.7 vs 3.4 days, P=0.001), better ROM at 1 week (94° vs 79°, P=0.008), lower VAS scores at day 3 (4.0 vs 6.0, P=0.02), and shorter hospital stay (5.0 vs 6.7 days, P=0.03). Blood loss was slightly higher in the SV group (360.5 vs 340.2 mL, P=0.76). Immobilization-related complications were lower in the SV group (3.3% vs 10%, P=0.24). CONCLUSIONS The SV approach enhanced early mobilization and rehabilitation in older patients, potentially reducing immobilization-related complications, despite slightly higher blood loss. These findings suggest that the subvastus approach may be preferable in geriatric patients to enhance recovery outcomes.

Cranial titanium mesh exposure is a challenging complication after cranioplasty and may lead to infection, cerebrospinal fluid (CSF) leakage, and soft-tissue defects. The authors report a patient with recurrent cranial titanium mesh exposure and scalp ulcer who underwent removal of the implant and reconstruction using a free anterolateral thigh (ALT) flap. Nursing management focused on intensive free-flap monitoring, infection prevention, CSF leak management, nutritional optimization, and early rehabilitation within a multidisciplinary framework. Hourly assessment of flap color, temperature, and capillary refill was performed during the early postoperative period. A postoperative CSF leak was successfully controlled with lumbar drainage. Targeted antibiotics and meticulous wound care prevented deep infection. The flap survived completely, and the patient regained independent mobility at discharge. This case highlights the important role of nurse-led multidisciplinary management in optimizing outcomes after complex cranial reconstruction.

Achilles tendon rupture impairs the functional performance of the triceps surae muscle-tendon unit. However, long-term effects of different rehabilitation programs on these impairments remain unclear. This study evaluated the long-term effects of early rehabilitation versus cast immobilization after Achilles tendon repair. We also examined whether the uninjured side could serve as a reference for the "healthy" side. Males with previous Achilles tendon rupture (n=20) and a group of healthy male controls (CTR; n=10) participated. Achilles tendon rupture participants included a short-term physical therapy group (STPT; n=10) and a plaster cast group (PC; n=10). Triceps surae morphology of the injured leg and ankle functionality of both injured groups was compared with that of the uninjured leg and with that of CTR legs. No between-group differences were found in the patient-reported outcomes. The injured side presented lower heel rise height, plantar flexors strength, gastrocnemius medialis thickness, calf volume, and shorter fascicle length than CTR. On the injured side, the STPT preserved ankle range of motion and showed greater plantar flexion and total range of motion than the PC. We employed a computational model that demonstrated that tendon elongation was the main determinant of heel rise height deficit. The uninjured side presented lower heel rise height than the CTR group. Despite favorable patient-reported outcomes, long-term structural and functional deficits persist after Achilles tendon rupture, regardless of rehabilitation approach. Findings suggest that the rehabilitation programs used did not fully restore muscle-tendon function and highlight limitations of using the uninjured side as a control.

ABSTRACT Context/Objective Metabolic disturbances are well documented in chronic spinal cord injury (SCI), yet data regarding metabolic, inflammatory, and hemodynamic profiles during the subacute rehabilitation period remain limited. This study aimed to determine the prevalence of metabolic syndrome and to examine metabolic, inflammatory, hemodynamic, and functional characteristics of adults with subacute SCI during early inpatient rehabilitation. Design Retrospective observational study. Setting Inpatient rehabilitation clinic. Participants A total of 87 adults with traumatic or non-traumatic SCI more than six weeks post-injury. Interventions Participants underwent a structured inpatient rehabilitation program consisting of multidisciplinary therapy, including physical and occupational therapy. Outcome Measures Sociodemographic and injury-related variables, American Spinal Injury Association (ASIA) Impairment Scale (AIS), laboratory parameters (fasting glucose, lipid profile, complete blood count), neutrophil-to-lymphocyte ratio (NLR), blood pressure, and Functional Ambulation Scale (FAS) scores at admission and discharge. Metabolic syndrome was defined using standard biochemical criteria. Results The mean age was 40.5 ± 19.6 years, and 78.2% of patients were male. Metabolic parameters remained within normal limits across AIS grades and lesion levels. Metabolic syndrome was present in 10.3% of patients. No statistically significant differences in NLR values were observed across AIS groups. Blood pressure remained stable across groups. Functional ambulation improved from a mean FAS score of 0.61 at admission to 1.06 at discharge. Conclusion Structured inpatient rehabilitation in the subacute phase of SCI appears to support early improvements in ambulation while maintaining metabolic, inflammatory, and hemodynamic stability. Larger longitudinal studies are needed to clarify the long-term significance of these findings.

To evaluate visual function in children with cerebral visual impairment (CVI) from various causes, examine its relationship with the severity of cerebral involvement using a semi-quantitative MRI scoring system (sqMRI), and compare the results with strabismic controls without visual impairment. This retrospective study included children diagnosed with CVI and controls without CVI who were followed for strabismus. MRI data were compared using a modified 24-point sqMRI scale. Inter-rater agreement was excellent (ICC = 0.91; 95% CI: 0.79-0.96). Partial correlations controlling for gestational age were computed for primary MRI-BCVA relationships. Forty-two children with CVI and 40 strabismic controls were included. Hypoxic-ischemic encephalopathy was the most common cause (26.1%). Children with CVI had significantly lower gestational ages, birth weights, and best-corrected visual acuity (BCVA) (mean 0.28 ± 0.17 logMAR) compared to controls (0.05 ± 0.05 logMAR) (p < 0.001). The sqMRI scores showed significant correlation with BCVA, especially in the basal ganglia, thalamus, hemispheric, subcortical, and total MRI scores (p < 0.05). The total MRI-BCVA correlation remained strong after adjusting for gestational age (partial r = 0.78, p < 0.001). A strong, prematurity-independent correlation was observed between sqMRI scores and visual impairment in a clinically diverse CVI population. These findings suggest that sqMRI scoring could be a useful additional tool for visual prognosis and early rehabilitation planning.

Chronic insertional rupture of the tibialis anterior tendon is uncommon and presents substantial reconstructive challenges, particularly when associated with large tendon defects and distal degeneration. Primary repair is often not feasible in such cases, and conventional reconstructive techniques frequently require prolonged postoperative immobilization, delaying functional recovery. We report a case of chronic insertional tibialis anterior tendon rupture in a 64-year-old Japanese male recreational weightlifter, treated with reconstruction using an ipsilateral semitendinosus autograft. A modified side-locking loop suture technique was employed for proximal fixation, and anatomical distal fixation was achieved using multiple all-suture anchors. This construct was designed to provide sufficient initial biomechanical stability to permit early postoperative rehabilitation. Postoperatively, the ankle was immobilized for 2weeks, followed by initiation of active range of motion exercises and progressive weight-bearing. At the 2-year follow-up, the patient demonstrated complete pain relief, normal gait, and excellent functional recovery. Isokinetic testing revealed dorsiflexion strength exceeding 95% of the contralateral side, and magnetic resonance imaging confirmed continuity and favorable remodeling of the reconstructed tendon. This case demonstrates that reconstruction of chronic insertional tibialis anterior tendon rupture using a semitendinosus autograft combined with a modified side-locking loop suture and multi-anchor fixation can provide sufficient stability to allow early functional rehabilitation. This approach may represent a viable treatment option for active patients with large tendon defects.

ObjectivesAs fatigue is among the most frequent manifestations of post-COVID syndrome (PCS), this study aimed to assess the prevalence and severity of cognitive and physical fatigue after occupational SARS-CoV-2 infection and to identify sociodemographic, clinical and occupational predictors of fatigue severity.DesignCross-sectional analysis of a multicentre prospective registry.SettingSix German Social Accident Insurance hospitals distributed across Germany, providing standardised post-COVID assessments for individuals with persistent symptoms following occupational SARS-CoV-2 infection.ParticipantsWorkers with confirmed SARS-CoV-2 infection recognised as an occupational disease or work-related accident who presented with persistent symptoms and were enrolled in a multicentre post-COVID registry.Primary and secondary outcome measuresCognitive and physical fatigue severity assessed using validated self-administered questionnaires (Fatigue Scale for Motor and Cognitive Functions, Modified Fatigue Impact Scale and Würzburg Fatigue Inventory for Multiple Sclerosis). Clinical relevance was determined based on established cut-offs reported in the literature. Fatigue severity was operationalised using median splits of the respective subscales to identify factors associated with higher fatigue levels.ResultsAmong 1511 registry cases, 628 participants had complete fatigue data. Median age was 54 years, 77% were female and most worked in nursing (43%) or educational/care professions (19%). Clinically relevant fatigue was highly prevalent: cognitive fatigue affected 78%–93% and physical fatigue 87%–98%. Both fatigue dimensions were positively correlated with older age, work incapacity and persistent symptom burden. In multivariate analyses, a higher number of acute symptoms was associated with lower odds of cognitive fatigue (adjusted OR 0.39, 95% CI 0.19 to 0.81), while physical fatigue remained associated with profession (adjusted OR 2.04, 95% CI 1.17 to 3.59). Sex, pre-existing conditions, hospitalisation and variant wave were not significant predictors in either model.ConclusionsFatigue is a prevalent and disabling PCS-symptom among occupationally exposed workers. Distinct determinants of cognitive and physical fatigue emphasise the need for early recognition, targeted management and rehabilitation strategies to support recovery and work reintegration.

Obstructed mixed-type total anomalous pulmonary venous connection (TAPVC) is a rare life-threatening congenital heart defect requiring urgent, high-risk surgery. Postoperative care is complex and fraught with complications. Enhanced recovery after surgery (ERAS) is a multimodal, evidence-based approach to optimize perioperative care, yet its application in neonatal cardiac surgery is nascent. A 12-day-old male infant presented with lethargy, poor feeding, and severe respiratory distress (SpO 2 80%-85%), requiring immediate intubation. Examination revealed diminished mental responsiveness and signs of poor perfusion. Obstructed mixed-typeTAPVC with an atrial septal defect, a ventricular septal defect, a patent ductus arteriosus, and severe pulmonary hypertension. The infant underwent surgical correction. Postoperatively, a comprehensive, nursing-led ERAS protocol was implemented. Core interventions encompassed goal-directed fluid therapy, proactive respiratory support to prevent pulmonary hypertensive crises, standardized sedation, early complication surveillance (thrombosis, capillary leak syndrome), and structured early rehabilitation. The infant was successfully weaned from mechanical ventilation on postoperative Day 5, achieved full oral feeding by Day 13, and was discharged on Day 18. This recovery timeline compares favorably to published data for similar complex cases. At the 3-month follow-up, he demonstrated age-appropriate growth and development with no significant cardiac sequelae. A structured, nursing-driven ERAS protocol is a valuable clinical tool to enhance outcomes, accelerate recovery, and reduce complications in high-risk neonatal cardiac surgery. This case affirms the pivotal role of neonatal nurses in perioperative care.

Purpose The purpose of this study was to understand the experiences and perspectives of rehabilitation clinicians regarding the trial of a new early vocational rehabilitation service for people with traumatic injury within an existing rehabilitation service, and to identify the critical facilitators, barriers, and key learnings. Materials and Methods A descriptive qualitative approach was used. Semi-structured interviews were conducted with eleven clinicians, and data analysed inductively using reflexive thematic analysis. Results Six themes were identified: Recognition that work is central in people’s lives; Valuing dedicated vocational expertise and focus; Early vocational rehabilitation resources are best used for those likely to gain the most; Timing needs to be person-centred and flexible; Importance of continuity of engagement; and Experiences of embedding a new service. Conclusions Early vocational rehabilitation for people following traumatic injury during inpatient care was highly valued by the team due to the perceived expertise and dedicated time of the vocational therapists for addressing vocational needs. It is important to consider which inpatients will benefit most from the service, and ensure appropriate timing is based on individual patient needs. Adequate team education, and clear processes for communication are important for successful integration of the service.

Infective endocarditis is an infectious heart disease strongly associated with morbidity and mortality. Up to half of the patients with infective endocarditis require heart valve surgery. While early exercise-based rehabilitation is well documented for patients recovering from heart surgery for non-infective endocarditis, there is limited research on those who have undergone valve surgery due to this infection. This study aimed to explore the early aerobic training in this patient population. A single-centre prospective feasibility study was conducted using the UK Medical Research Council's framework for complex interventions. The study investigated the feasibility (recruitment, retention, adherence), safety, acceptability, and preliminary functional outcomes of 4 × 4 interval training in this patient population. Training session data included the number, duration, and intensity, which were monitored via the Apple Watch S5 (Present Age-Predicted Maximum Heart Rate) and the Borg RPE scale. Functional outcomes were evaluated at baseline and 3 months post-surgery, including sub-maximal oxygen uptake (treadmill protocol), 6-min walk test, and quality of life (HeartQoL, EQ-5D-5L). Sixteen patients consented to participate, with 12 initiating the intervention and 11 completing it, yielding a retention rate of 91.7%. Training adherence averaged 73.1% of the minimum expected sessions, with high participant satisfaction and no serious adverse events reported. At the 12-week follow-up, participants demonstrated measurable change in functional capacity, including an increase in workload capacity (+ 95 W), METs (+ 3.4), and 6-min walk test distance (+ 219m). Health-related quality of life also showed a noticeable increase, with HeartQoL physical and emotional scores increasing by 1.0 and 1.3, respectively, and EQ-5D-5L VAS scores rising by 17.2. The EQ-5D-5L index increased from 0.61 at baseline to 0.87 after 12weeks. Interval training, when conducted with appropriate safeguards and tailored to individual needs, is a feasible and safe intervention for patients recovering from endocarditis and cardiac surgery. The observed improvements in functional capacity, quality of life, and patient satisfaction support the need for larger controlled studies. Clinical Trials, ID NCT05703022. Registered on 25 November 2021, http://www. gov.

BackgroundHip fractures (HF) are a serious and increasingly common condition in the geriatric population. Favorable clinical outcomes require early postoperative rehabilitation, which relies on effective pain management. Intrathecal morphine (ITM) is a well-established method of perioperative analgesia, but concerns have been raised about potential adverse effects in the elderly population. This superiority trial was designed to compare the efficacy and safety of low-dose intrathecal morphine, with adverse effect prevention, versus a standard multimodal analgesic regimen in elderly patients undergoing surgery for hip fracture repair.MethodsPatients aged 60–90 years scheduled for HF surgery under single spinal anesthesia were randomized into two groups: bupivacaine/levobupivacaine with 100 µg ITM, and bupivacaine/levobupivacaine alone. The primary outcome was pain intensity (11-point numeric rating scale; NRS) during the first 24 hours after surgery. Secondary outcomes included postoperative analgesic consumption, time to first analgesic, and incidence and severity of adverse effects.ResultsThis study enrolled 82 patients; 47 (57.3%) were allocated to the intervention group, 34 (41.5%) to the control group. The median 24-hour postoperative NRS score was 0.39 (IQR 0.00–0.90) in the intervention group, and 1.70 (IQR 1.23–1.91) in the control group (p < 0.001). Time to first analgesic was 16.5 hours (IQR 8.75–24.00) in the intervention group, and 7 hours (IQR 4.62–9.88) in the control group (p < 0.001). No postoperative analgesics were required for 29.8% of patients in the intervention group, and 2.9% of patients in the control group (p = 0.001). The incidence and severity of adverse effects did not significantly differ between the groups.ConclusionCompared to standard multimodal analgesia, low-dose ITM significantly reduced postoperative pain and analgesic consumption, and prolonged the time to first analgesic administration, without an increased incidence or severity of adverse effects in elderly patients with HF.

Robotic-assisted rehabilitation has been used to release the labor burden in manual practice for early stroke rehabilitation. However, its broader application is constrained by high costs, limited accessibility, and high dependence on professional operation. This study aimed to investigate the feasibility and effectiveness of semi-independent, bedside upper limb rehabilitation assisted by a wrist-hand exoneuromusculoskeleton (WH-ENMS) for individuals with subacute stroke via a randomized controlled trial compared with the outcomes achieved by conventional therapy and training programs assisted by an interlimb-coordinated (IC) robot. Fifty-four participants with subacute stroke were randomized into three groups: ENMS, IC, or conventional therapy. All groups underwent 21 rehabilitation sessions (60min/day for 21 consecutive days), each including 30min of standardized Bobath therapy. During the additional 30min of training, the ENMS group engaged in semi-independent bedside training with minimal supervision, the IC group received supervised IC cycling, and the conventional group received proprioceptive neuromuscular facilitation. The rehabilitative effects were evaluated via clinical scores. The primary outcome was the Fugl-Meyer Assessment-Upper Extremity (FMA-UE), and the secondary outcomes included the action research arm test (ARAT), modified Ashworth scale (MAS), and modified Barthel index (MBI). The manpower consumption was quantified on the basis of the professional hours required during training. The ENMS group required significantly less total occupational therapist (OT) involvement (11.6h) compared with the IC (22.9h) and conventional (21.0h) groups, representing a 49.4% reduction in professional manpower demand. All groups showed significant improvements in FMA-UE, ARAT, and MBI scores. Compared with the other groups, the ENMS group achieved superior gains in voluntary motor function (FMA-UE and ARAT, P < 0.05). The ENMS group also obtained significant reductions in muscle spasticity across multiple joints (MAS, P < 0.05). The IC group demonstrated the largest MBI improvements, while the conventional group showed greater gains in hand function than the IC group (P < 0.05). Semi-independent bedside rehabilitation with WH-ENMS is feasible, safe, and effective for inpatients with subacute stroke. It reduced the demand for professional manpower while promoting upper limb recovery, particularly wrist-hand function, during the critical subacute neuroplasticity window. This approach could optimize rehabilitation resource allocation and facilitate more personalized interventions. Trial registration Chinese Clinical Trial Registry Identifier: ChiCTR2300074469. Registered on 2023/08/08.

Isolated greater tuberosity (GT) fractures account for approximately 20% of proximal humeral fractures and are frequently associated with glenohumeral dislocation and rotator cuff injuries. Displacement exceeding 5mm is recommended for surgery to prevent subacromial impingement and functional impairment. Current fixation methods, such as cannulated screws, suture anchors, and locking plates, each have limitations, including inadequate stability for comminuted fractures, risk of impingement, and suboptimal anatomical adaptation. This underscores the necessity of a hybrid technique that integrates the benefits of both soft tissue and rigid fixation. This retrospective study analyzed 12 patients with comminuted split-type or avulsion-type greater tuberosity fractures treated with a hybrid surgical technique from January 2023 to June 2025. A deltopectoral approach was utilized to achieve fracture reduction, which was temporarily stabilized via K-wires. Two anchors were placed at the greater tuberosity, and a double-row suture technique was employed, with the sutures secured through an external row anchor arranged in a parachute configuration. A low-profile anatomic locking plate was subsequently applied to provide buttress support, resulting in a composite construct referred to as a "suture plate." The outcomes measured included operative time, blood loss, Constant-Murley and ASES scores, VAS pain scores, and radiographic healing status. All patients were followed up for a mean duration of 11.3 ± 5.0 months. The mean operative time was 82.5 ± 15.8min, and the mean blood loss volume was 170.8 ± 52.6ml. All fractures achieved clinical union at a mean of 11.0 ± 1.5 weeks, with no instances of anchor pullout, suture cutout, or implant failure. The Constant-Murley scores improved from 30.5 ± 4.8 preoperatively to 90.3 ± 3.7, the ASES scores improved from 32.1 ± 5.8 to 89.4 ± 3.6, and the VAS scores decreased from 6.8 ± 2.1 to 1.0 ± 0.6. Excellent or good outcomes were observed in 91.7% (11/12) of the patients. The combination of the double-row parachute suture technique and a low-profile anatomic locking plate provides a hybrid fixation system that integrates flexible and rigid stabilization. This construct can provide reliable fixation, supporting early rehabilitation, and yielding satisfactory short-term functional outcomes for comminuted split-type or avulsion-type greater tuberosity fractures, representing a potentially feasible alternative to conventional methods, although further high-level studies are required to confirm its long-term efficacy and safety.