To describe the clinical outcomes during the 2 years after open reduction and internal fixation (ORIF) with a volar locking plate for distal radius fractures (DRFs) in men and to identify associated factors. We retrospectively reviewed 109 men who underwent ORIF for DRFs between September 2016 and January 2021 with a minimum 2-year follow-up. Wrist range of motion, grip strength, pain visual analog scale, and disabilities of the arm, shoulder, and hand (DASH) scores were assessed at 3 months, 1 year, and 2 years postoperatively. Longitudinal changes in DASH scores were analyzed using a linear mixed-effects model adjusted for patient, fracture, and treatment-related factors. Grip strength and DASH scores improved over time. Compared with 3 months, DASH scores decreased by 11.3 points at 1 year and 13.9 points at 2 years (both p < 0.001). Older age was independently associated with worse DASH scores (β = 0.318 per year, p < 0.001), most markedly at 3 months (age-by-time interaction, p = 0.016). Workers’ compensation status was associated with poorer DASH scores (β = 8.732, 95
Post-traumatic stress disorder (PTSD) is increasingly recognized as a factor that may impact surgical recovery. Currently, its effect on outcomes following anterior cervical discectomy and fusion (ACDF) remains unclear. This study investigates whether a preoperative diagnosis of PTSD is associated with increased postoperative healthcare utilization. A retrospective, multi-institutional cohort study was performed using a large electronic medical record database. Patients undergoing primary, single-level ACDF were identified and stratified by the presence of PTSD diagnosis before surgery. Propensity score matching was performed in a 1:1 ratio using over 300 demographic and clinical variables. Outcomes were assessed at 30 days, 90 days, and two years postoperatively. A total of 3774 patients were included after matching, with equal distribution between cohorts. Patients with PTSD had increased opioid utilization at both 30 days (OR: 1.4, 95
Ankle fractures frequently involve syndesmotic disruption, requiring stable fixation to restore joint function. Syndesmotic screw fixation remains widely used but carries significant drawbacks, including implant breakage, stiffness, and frequent need for removal. Suture button stabilisation offers clinical and economic advantages by preserving physiological motion and reducing reoperation rates. This study evaluates these costs under normal, unselected clinical practice, where implant choice and removal decisions were made independently by treating surgeons without protocol influence. This retrospective cohort study compares treatment costs of syndesmosis screw fixation and suture button stabilisation for syndesmotic injuries in a single UK Major Trauma Centre. 75 patients aged 16–60 years, with length stable or length stabilised ankle fractures with syndesmotic injuries, between October 2020 to October 2023 were included. The two cohorts were demographically similar and operative times were comparable (p = 0.170). Complications and reoperations were significantly higher with screw fixation (p < 0.001), with 56.8
To evaluate the effectiveness of Virtual reality (VR) simulation training compared with traditional teaching methods for residents and early-career surgeons training in pedicle screw insertion. PubMed, Embase, and the Cochrane Library were systematically searched from inception to December 2025. Randomized controlled trials (RCTs) comparing VR simulator training with traditional training approaches for pedicle screw placement in residents and early-career surgeons were included. A random-effects model was applied to pool outcomes, with treatment effects expressed as mean differences or risk ratios with 95
Bone mineral-reducing medications (BMRMs) are commonly prescribed, but their association with outcomes after ankle open reduction and internal fixation (ORIF) is unclear. We evaluated preoperative exposure to ten BMRM classes and two-year complications after ankle ORIF. Adults undergoing ankle ORIF at least two years before data extraction were identified in TriNetX. Exposure required at least one medication record 1–180 days before surgery for proton pump inhibitors (PPIs), glucocorticoids, loop diuretics, thiazolidinediones, calcineurin inhibitors, aromatase inhibitors, selective serotonin reuptake inhibitors (SSRIs), first- or second-generation antipsychotics, or antiepileptics. Exposed patients were 1:1 propensity score matched to patients unexposed to all classes. Risk ratios (RRs) for five two-year outcomes were adjusted for false discovery rate (FDR). Matched cohorts included 227–9,858 patients per group. Nonunion was more frequent with glucocorticoids (2.36
