Journal of orthopaedic trauma
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Early Definitive Fixation and Risk of Deep Surgical-Site Infection After Tibial Plateau ORIF: A Systematic Review and Meta-analysis

Jun 19, 2026

The authors aimed to determine whether early definitive fixation of tibial plateau fractures (TPF) reduces the risk of deep surgical-site infections (SSI) compared to delayed fixation. Their systematic review and meta-analysis of nine studies involving 1,412 patients found that early fixation within 72 hours was associated with a significantly lower risk of deep SSI and overall infection, although no significant differences were observed for other complications. The findings suggest a potential benefit of early fixation, but the authors caution that causality cannot be established from this analysis.

Fragmented Sleep And Opioid Medication Utilization During Hospitalization Following Orthopaedic Trauma

Jun 19, 2026

The authors aimed to characterize sleep patterns in hospitalized patients following orthopaedic trauma and assess their relationship with opioid medication use. The study found that patients experienced short and fragmented sleep, with higher opioid utilization correlating with decreased sleep duration. Specifically, each additional morphine milligram equivalent of opioid use was associated with an average reduction of 2.7 minutes of sleep per day.

Reliability of modified Radiographic Union Scale for Tibial Fractures (mRUST) Scores in Ballistic Lower Extremity Trauma

Jun 19, 2026

The authors aimed to evaluate the reliability of the modified Radiographic Union Scale for Tibial Fractures (mRUST) in assessing union status in patients with ballistic lower extremity trauma and to determine the predictive value of 3-month mRUST scores for nonunion at 9 months postoperatively. The study found that while mRUST scores demonstrated moderate inter- and intra-rater reliability in ballistic fractures, they were effective in predicting nonunion in ballistic femoral fractures but only moderately so for tibial fractures.

Patient-Reported Outcomes After Distal Radius Fractures Differ Across Geographic and Cultural Populations: A Global Systematic Review and Meta-Analysis

May 27, 2026

The authors aimed to evaluate the heterogeneity of patient-reported outcomes (PROs) following volar plate fixation of distal radius fractures across different cultural and geographic populations. Through a systematic review and meta-analysis of randomized controlled trials, they found significant variations in PRO scores, such as DASH, PRWE, and VAS, indicating that outcomes are not universally applicable and differ meaningfully across cultural contexts.

Technical Tricks to Improve Iliosacral Screw Safety Using 3D CT Imaging

May 27, 2026

The authors investigate how 3D CT imaging can enhance the safety of iliosacral screw placement in surgical procedures. They aim to identify technical strategies that leverage advanced imaging techniques to minimize complications and improve outcomes in patients undergoing this type of surgery.

Nail Plate Constructs Permit Early Weight Bearing and Improved Outcomes Compared to Single Device Constructs in the Treatment of Distal Femur Fractures at One-Year Follow-Up: A Retrospective Analysis

May 27, 2026

The authors aimed to compare clinical, radiographic, and patient-reported outcomes between single device constructs (lateral locked plate or intramedullary nail) and nail-plate combination constructs in the surgical treatment of distal femur fractures. Their findings indicated that the nail-plate combination resulted in lower rates of nonunion, reoperation, and gait impairment, while allowing for earlier weight bearing and improved discharge outcomes at one year post-operation. These results suggest that nail-plate constructs may offer significant benefits, particularly for geriatric patients and those with complex fracture patterns.

Single Antibiotic Use with Ceftriaxone for Prophylaxis of All Open Fractures

May 27, 2026

The authors aimed to evaluate the effectiveness of a prophylactic antibiotic protocol using ceftriaxone for all open fractures compared to a traditional regimen that varied based on fracture type. Their findings indicated that ceftriaxone was non-inferior to the classic protocol regarding deep infection rates and was associated with a shorter time to antibiotic administration, suggesting it may be a safe and efficient standard for treating open fractures. However, the study's power was limited to detect significant differences in deep infection rates.

Comparative Analysis of Nail Plate Combination over Alternative Fixation Constructs in Low Energy Distal Femur Fractures: Recovery of Ambulatory Status and Outcomes

May 27, 2026

The authors aimed to compare the outcomes of patients with low-energy distal femur fractures treated with the Nail Plate Combination (NPC) versus alternative fixation constructs, specifically focusing on ambulatory status, union rates, mortality, and complications. The study found that NPC provided superior ambulatory recovery and lower mortality rates compared to retrograde intramedullary nails, suggesting it is a reliable option for early recovery in these injuries.

Temporal Effects on Intra-operative Bacterial Contamination of Surgical Gloves in Non-Infection Orthopaedic Trauma Cases

May 27, 2026

The authors aimed to investigate the temporal dynamics of bacterial contamination on surgical gloves during non-infection orthopedic trauma surgeries and its potential contribution to surgical site infections (SSIs). They found that 25.4% of sampled gloves showed bacterial growth, with contamination rates increasing over time, particularly after implant placement and in pelvic procedures. The study suggests that implementing routine glove changes after specific time intervals could be an effective strategy to reduce the risk of SSIs.

Reproducibility of Two Novel Bone Defect Classification Systems

May 12, 2026

The authors aimed to assess the reproducibility of two novel bone defect classification systems: the Tetsworth classification and the Universal Long Bone Defect (ULBD) classification. Their findings indicated that the Tetsworth classification demonstrated fair to moderate agreement among surgeons, suggesting it is suitable for future research, while the ULBD classification exhibited low overall reproducibility.