Skin Advanced Glycation End Products (AGEs) are not associated with bone mineral density longitudinally: The Rotterdam Study.

Bone mineral density response to romosozumab in post-menopausal women: A prospective observational real-world study.

The association between body roundness index and lumbar marrow fat content in postmenopausal women.

Enhanced opportunistic CT screening for osteoporosis using Machine learning derived volumetric vertebral and complementary body composition information.

Relation Between Prosthetic Joint Infections and Haematoma Contamination in Acute Fracture of the Neck of Femur

Outcomes of Proximal Femoral Replacement for Nononcologic Indications in Australia.

Secular trends in femoral measurements and their implications for skeletal sex estimation in the Portuguese population.

To evaluate the safety and efficacy of a novel three-dimensional triangular external fixator (3D-TEF) in combination with proximal femoral derotational osteotomy (PFDO) for the treatment of symptomatic excessive femoral anteversion (EFA). A retrospective analysis was conducted on data from 12 patients (23 limbs) who underwent PFDO with 3D-TEF from July 2018 to 2024. The preoperative and postoperative femoral neck anteversion angle (FNA) was measured using computed tomography scans, quality of life was assessed using the Pediatric Outcomes Data Collection Instrument (PODCI), and complications and bone healing time were recorded. Twelve patients underwent surgery on a total of 23 limbs, with a mean age of 10.4 years (7.00-17.00). The mean follow-up duration was 23.25 months (5.00-44.00). The preoperative FNA was 42.58 ± 7.57°, which significantly decreased to 17.99 ± 2.14° postoperatively ( t = 15.34, P < 0.001). The mean femoral neck-shaft angle measured 136 .25° ± 4. 26° preoperatively and 136.80° ± 4.24° postoperatively (t = -0.77, P > 0.05), indicating no statistically significant change. Postoperative PODCI scores approached normative levels. All patients showed improvement in symptoms of tripping and falling, as well as in the degree of FNA. Two complications were observed: one superficial pin tract infection and one knee flexion contracture, neither of which impacted final outcomes. All osteotomies achieved union without evidence of nonunion, malunion, delayed union, hardware loosening, or avascular necrosis. PFDO stabilized with the 3D-TEF yielded satisfactory outcomes in correcting EFA. The 3D-TEF may present itself as a viable alternative for treating EFA, offering positive clinical outcomes.

Orthopaedic emergencies demand rapid recognition and decisive action, particularly in resource-constrained or nontertiary settings where the community surgeon often serves as the first and only line of defense. It is important to provide a practical, evidence-informed guide for the management of musculoskeletal injuries, including irreducible joint dislocations, ultra-low-energy knee dislocations, open fractures with vascular compromise, compartment syndrome, and femoral neck fractures in young patients. Emphasis is placed on early diagnosis, stabilization strategies, soft-tissue management, and the integration of adjunct technologies. Technical pearls, decision-making frameworks, and contemporary research support timely intervention and optimize outcomes, especially in settings wherein access to subspecialty care may be limited.

Femoral neck fractures are common injuries sustained by patients of all ages and are caused by both low- and high-energy mechanisms. The physician must diagnose the fracture expeditiously to initiate treatment. The surgeon must then evaluate the patient's medical condition and fracture characteristics to determine a treatment regimen that will minimize the all-too-common risks of osteonecrosis and fixation failure or fracture nonunion. In elderly, frail, and inactive patients, hip arthroplasty is usually the best treatment. In younger patients, efforts should be directed at expedient reduction of the fracture and surgical stabilization with multiple screws or with a sliding compression screw construct. The rationale of proper patient selection and the intraoperative tactics for optimal results are important topics to be reviewed.

This research aims to investigate femoral neck anteversion (FNA) on the less involved side in unilateral cerebral palsy (CP) and examine its impact on hip rotation during gait. Sixty-nine patients with unilateral CP, with a mean of 21 years, were included study. Static and dynamic hip rotation ranges were quantified via physical examination and three-dimensional motion analysis. Patients were stratified into five levels of involvement according to modified Winters' classification. FNA differences between modified Winters' classification types and correlation with static and dynamic hip rotation were analyzed. Hip morphology was classified based on the Melbourne Cerebral Palsy Hip Classification Scale E&R. Regarding FNA, our analysis suggested a moderate correlation ( r = 0.61, P < 0.05) between both sides. Hip dysplasia was found in 20.5 and 23.1% of the less involved and more involved sides, respectively, in 39 patients. Increased FNA was associated with increased static hip internal and decreased external rotation for both sides ( P < 0.05). A positive correlation was observed between FNA and dynamic hip rotation on the more involved side ( P < 0.05). Conversely, on the less involved side, FNA showed no significant correlation with pelvic, hip, or knee rotation. This study demonstrates that in unilateral CP, the less involved side is also significantly affected, a moderate correlation exists between the two sides, and both hips may exhibit dysplasia. These findings underscore the necessity for a comprehensive bilateral clinical assessment. Long-term surveillance of both hips and consideration of the less involved side for surgical planning may be warranted.

Weekend surgery is associated with increased use of hemiarthroplasty for displaced femoral neck fractures: A propensity-matched study.

The anaesthetic management of parturients with sickle cell disease is fraught with significant challenges, with an increased perioperative risk of complications such as vaso-occlusive crisis, acute chest syndrome, and thromboembolism. An associated orthopaedic injury adds another layer to perioperative planning, demanding an individualised approach to maximise analgesia, enable appropriate positioning for anaesthesia, and ensure haemodynamic stability. This case discusses the anaesthetic management of a 22-year-old primigravida with sickle cell disease and hypothyroidism and a right femoral neck fracture who underwent elective caesarean section. Since positioning for neuraxial anaesthesia would be problematic due to pain and limited mobility, an ultrasound-guided femoral nerve block was performed using 15 mL of 2% lignocaine. This permitted the patient to be positioned in the sitting position for spinal anaesthesia without discomfort. Spinal anaesthesia was administered with 1.6 mL of 0.5% hyperbaric bupivacaine and 25 µg fentanyl, achieving a sensory block up to T6. The intraoperative course was uneventful, and haemodynamics were stable. A healthy newborn was delivered with good Apgar scores. Postoperative care involved adequate analgesia, hydration, oxygenation, and early prophylaxis for thromboembolism. The postoperative course was uneventful, with no sickle cell-related complications, and both mother and infant were discharged in stable condition. The case demonstrates the effectiveness of a combined regional anaesthesia technique in enhancing perioperative management in high-risk obstetric patients. The use of a femoral nerve block as an adjunct to spinal anaesthesia was a valuable, efficient, and safe procedure that minimised pain and enhanced the patient’s comfort, contributing to a favourable surgical outcome.

Intertrochanteric fracture occurring after surgery for femoral neck fracture in an adult

Fracture prediction by bone trait dis-integration using DXA among a clinical cohort of adults with cerebral palsy.

Background Existing classification systems for sequelae of pediatric septic arthritis of the hip (SAH) are notably complex. This study introduces a simplified radiographic classification—the Xi’an Honghui Hospital Paediatric Orthopaedic Classification (HHPO classification)—designed to enhance accuracy in treatment planning and prognostic evaluation. Methods A retrospective analysis was conducted involving 18 pediatric patients with SAH. Pelvic radiographs were evaluated to assess the structural integrity of the femoral head and neck and their spatial relationship with the acetabulum. Based on these assessments, the HHPO classification was developed. Six independent observers classified each case using both the HHPO and Choi systems. Interobserver reliability and two-week intraobserver consistency were assessed and compared between the two classifications. Results The distribution according to the HHPO classification was as follows: Type IA (n=5), Type IB (n=6), Type ID (n=2), Type IIA (n=3), and Type IIB (n=2). The HHPO system demonstrated significantly higher inter- and intraobserver agreement compared to the Choi classification. Clinically, severe hip pain was reported in 5 patients, occasional pain in 2, and no pain in 11. The majority of hips (88.9%) exhibited satisfactory range of motion, and 72.2% were radiologically stable. Earlier onset of infection was associated with more severe sequelae. Conclusion The HHPO classification is simpler, more reproducible, and demonstrates potential clinical utility for managing pediatric SAH sequelae in this cohort.

Clinical efficacy of personalized 3D-printed modular navigation templates in assisting Femoral Neck System implantation for femoral neck fractures in young and middle-aged adults.

Background and Objectives: Handgrip strength (HGS) is a simple marker of muscular fitness that has been linked to adverse outcomes in older adults, while menopause is accompanied by skeletal deterioration and increased psychological vulnerability. Resilience and self-regulation may be associated with lower levels of these risks, but their relationship with bone microarchitecture has not been clarified. We aimed to examine the associations between HGS and trabecular bone score (TBS), bone mineral density (BMD), mental health, resilience, and self-regulation in postmenopausal women. Materials and Methods: In this study, 200 postmenopausal women were recruited. HGS was assessed with a dynamometer, BMD at the lumbar spine, total hip and femoral neck by DXA, and lumbar TBS was derived from spine images. Psychological distress was measured with the DASS-21, resilience with the Brief Resilience Scale (BRS), and self-regulation with the Short Self-Regulation Questionnaire (SSRQ). Results: TBS was significantly higher in women with higher HGS (p &lt; 0.001). Higher HGS was also associated with lower anxiety and depression scores (p = 0.011 and p = 0.013), fewer self-reported mental health disorders, and greater resilience (p &lt; 0.001) and self-regulation (p = 0.004). Resilience and self-regulation were inversely related to all DASS-21 subscales (all p &lt; 0.001), and HGS correlated positively with BRS (p &lt; 0.001) and SSRQ (p &lt; 0.001). TBS correlated modestly with both BRS (p = 0.003) and HGS (p &lt; 0.001). In multiple linear regression, both BRS (β = 0.018, p = 0.013) and HGS (β = 0.003, p = 0.006) remained independently associated with TBS after adjustment for age, BMI, menopause duration, and SSRQ. Conclusions: In postmenopausal women, higher handgrip strength is associated to better trabecular bone microarchitecture and a more favorable psychological profile. Incorporating HGS and brief psychosocial assessment alongside TBS may enrich fracture risk stratification and support more integrated musculoskeletal and mental health care.

Upper-thoracic predominance and non-vertebral fracture burden in Parkinson's disease: A matched Case-Control study.

Trifocal femur fractures, characterized by fractures occurring at three distinct levels of the femur, are exceptionally rare injuries that usually result from high-energy trauma. Their management is challenging due to limited published evidence, complex fracture patterns, and the technical difficulty of achieving stable fixation across multiple segments. We present a case series of four patients with ipsilateral multilevel femur fractures, including trifocal injury patterns. Case 1 sustained a subtrochanteric fracture associated with a segmental shaft fracture; case 2 had an intertrochanteric fracture with a segmental shaft fracture; case 3 presented with intertrochanteric, shaft, and distal intra-articular femur fractures; and case 4 sustained fractures of the femoral neck, shaft, and distal femur. All patients underwent surgical management using individualized fixation strategies, including long proximal femoral nailing, cancellous screw fixation, bone grafting, and distal femoral plating as required. Radiological union was achieved in all fracture components except for incomplete union of the distal femur in one patient at two-year follow-up. Functional outcomes were satisfactory in all patients, with restoration of limb alignment, implant stability, and ambulatory function. Early recognition, meticulous preoperative planning, and stable fixation using appropriate load-sharing constructs are essential for achieving favorable outcomes in these complex injuries.