This study aimed to evaluate the positivity rate of transillumination among histopathologically confirmed subungual glomus tumors. We hypothesized that transillumination would demonstrate a high positivity rate comparable to those of commonly used diagnostic methods. The primary outcome was the positivity rate of the evaluated diagnostic methods, including the Love test, Hildreth test, preoperative transillumination, intraoperative transillumination, and preoperative magnetic resonance imaging (MRI). A retrospective study was conducted on 32 patients diagnosed with subungual GTs who underwent transungual surgical excision between January 2024 and January 2026. All patients were over 18 years old, had at least six months of follow-up, and underwent preoperative clinical tests, preoperative MRI, and transillumination assessment. Intraoperative transillumination was also performed. Positivity rates were compared using the exact McNemar test for paired binary data, with Bonferroni correction for multiple pairwise comparisons. Positivity rates were reported with 95
This study aimed to develop and internally validate a thrombosis biomarker-based model for the early identification of ultrasound-detected DVT after knee arthroplasty and to evaluate its discriminatory performance and potential clinical utility. A total of 376 patients undergoing knee arthroplasty were enrolled in this study, including 268 patients without thrombosis and 108 patients with thrombosis. Univariable and multivariable logistic regression analyses were employed to identify thrombosis biomarkers. Receiver operating characteristic (ROC) curves were used to evaluate the discriminatory performance of individual biomarkers and the subsequently developed combined biomarker model. The model was further validated using bootstrap methods. Its discriminative performance was evaluated by calculating the area under the curve (AUC), sensitivity, specificity, and Brier score, while calibration was assessed using calibration curves. The DVT group had a higher age and a lower platelet count (p < 0.05), while the levels of D-dimer, thrombin–antithrombin complex (TAT), plasmin–α2-plasmin inhibitor complex (PIC), and tissue-type plasminogen activator–plasminogen activator inhibitor-1 complex (t-PAIC) were significantly elevated (p < 0.001). Multivariable logistic regression analysis showed that TAT and t-PAIC remained independently associated with postoperative DVT, whereas D-dimer showed a borderline association. The combined model based on the aforementioned indicators achieved an AUC of approximately 0.75, indicating moderate discriminative ability. The model showed generally acceptable calibration and provided a positive net benefit across threshold probabilities of 0.10–0.40, with a Brier score of 0.18, indicating acceptable overall performance. The combined biomarker model incorporating D-dimer, TAT, and t-PAIC demonstrated moderate discriminatory ability and acceptable overall performance for the early identification of ultrasound-detected DVT after knee arthroplasty. The model may support early postoperative risk stratification and help identify patients who require closer surveillance or further imaging evaluation. However, external validation is required to confirm its generalizability and clinical utility before implementation.
To evaluate the clinical outcomes of percutaneous vertebroplasty (PVP) via Kambin’s triangle in older patients with spinal deformity and osteoporotic vertebral compression fractures (OVCFs). We retrospectively reviewed 31 patients with spinal deformity and OVCFs treated between January 2019 and December 2022. The cohort comprised 13 men and 18 women aged 60–84 years (mean, 70 ± 10.3 years), with symptom durations of 1–6 weeks (mean, 3.5 ± 1.7 weeks). Thirty-five vertebrae were treated. Fifteen patients (17 vertebrae) underwent unilateral PVP via Kambin’s triangle, whereas 16 patients (18 vertebrae) underwent unilateral transpedicular PVP. Patient-level outcomes included VAS, ODI, and complications; vertebra-level outcomes included operative time, fluoroscopic acquisitions, cement leakage, and cement distribution. A total of 31 patients with 35 treated vertebrae were included. Group A comprised 15 patients with 17 treated vertebrae, and Group B comprised 16 patients with 18 treated vertebrae. Mean operative time was 25 ± 5.7 min per vertebra in Group A and 33 ± 7.2 min per vertebra in Group B. Mean fluoroscopic acquisitions were 6.2 ± 1.6 and 9.3 ± 1.8 per vertebra, respectively. After Bonferroni correction, operative time (adjusted P = 0.019) and fluoroscopic acquisitions (adjusted P < 0.001) remained statistically significant. Cement leakage occurred in 0 of 17 treated vertebrae in Group A and 2 of 18 treated vertebrae in Group B. Uniform cement dispersion was observed in 12 of 17 vertebrae (70.59
To investigate the low-dose computed tomography (LDCT) imaging characteristics of LDCT-detected postoperative recurrence after radical lung cancer resection, analyze their spatiotemporal distribution patterns, and identify associated clinicopathological risk factors. The primary estimand is the distribution and imaging appearance of recurrence first identified during institutional LDCT surveillance, not the overall incidence of recurrence after curative lung cancer surgery. A retrospective cohort study. Electronic medical records and the institutional Picture Archiving and Communication System (PACS) from a tertiary hospital database between January 2018 and December 2023. This study analyzed a cohort of 150 patients who underwent curative lung cancer resection and completed at least 2 years of postoperative LDCT follow-up, with first recurrence detected by LDCT (isolated brain or bone recurrences detected by other modalities were excluded). This is therefore a cohort of LDCT-surveillance completers with LDCT-detected first recurrence, and the findings describe recurrence patterns within this specific cohort rather than estimating overall post-resection recurrence. Patients were divided into recurrence (n=45) and non-recurrence (n=105) groups. LDCT features (95th percentile CT value, mean CT value, volume), recurrence timing, and patterns (locoregional vs. distant) were analyzed. Fine-Gray competing-risk models were used to estimate cumulative incidence of recurrence, and penalized ridge regression with bootstrap internal validation was used to identify predictors of recurrence. Among 45 recurrence patients, most recurrences occurred between 3 and 12 months post-surgery (55.55
This study aimed to evaluate the midterm clinical and radiographic outcomes of simultaneous bilateral proximal fibular osteotomy (SBPFO) for bilateral medial compartment knee osteoarthritis (MKOA), including changes in lower-limb alignment, the adjacent hip, patellofemoral, and ankle joints, and the lateral tibial plateau. This single-centre, single-arm retrospective cohort study identified 59 patients with bilateral MKOA who underwent SBPFO between 2018 and 2020. All 59 treated patients were included in the safety and survivorship analyses, whereas the final clinical and radiographic analyses included 55 patients who completed follow-up with both native knees. Among these 55 patients, the mean follow-up was 7.03 ± 0.57 years. Radiographic parameters were measured preoperatively and at final follow-up. Lower-limb alignment was assessed using the hip–knee–ankle angle (HKA), weight-bearing line ratio (WBLR), joint line convergence angle (JLCA), femorotibial angle (FTA), and settlement value. Adjacent-joint parameters included the hip abduction angle (HAA), acetabular index (AI), Sharp angle, knee–ankle joint angle (KAJA), talar tilt angle (TT), and tibial plafond inclination (TPI). Patellofemoral parameters included the posterior tibial slope (PTS), tibial tubercle prominence (TTP), Blackburne–Peel index (BPI), and Caton–Deschamps index (CDI); lateral tibial plateau changes were assessed using lateral plateau widening (LPW) and fibular height (FH). Clinical outcomes were assessed using the Visual Analogue Scale (VAS), Hospital for Special Surgery (HSS) knee score, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and range of motion (ROM). Primary analyses were performed at the patient level using the mean of both knees (n = 55), paired t tests, and Bonferroni correction; mixed-effects models were fitted as sensitivity analyses. Among the 55 patients included in the final clinical and radiographic analysis, the mean follow-up was 7.03 ± 0.57 years (range, 6.0–8.5 years). In the safety and survivorship cohort of 59 treated patients, primary wound healing was achieved in all patients, and one patient experienced transient toe numbness that resolved spontaneously within 3 months. One patient underwent unilateral conversion to TKA at 58 months after surgery and was considered a treatment failure. Patient-level Kaplan–Meier survivorship free from any conversion to knee arthroplasty was 98.3
