Journal of Medical Bioscience

Surgical management and decision making in osteoporotic vertebral compression fracture

2025-12-23T09:10:48+07:00

Osteoporotic vertebral compression fracture (OVCF) is a common condition in the elderly. Although it can often be managed conservatively, some patients may experience severe pain, progressive kyphosis, or neurological injury. In these cases, surgical treatment plays a crucial role. Current treatment guidelines, such as those from The German Society of Orthopaedics and Trauma (DGOU), often use the Osteoporotic Fracture (OF) classification based on fracture morphology to guide decisions between conservative and surgical management and to recommend specific operative techniques. Various surgical modalities exist, including cement augmentation (vertebroplasty/kyphoplasty), posterior instrumentation and fusion, and anterior instrumentation and fusion. However, surgery in osteoporotic patients is highly challenging due to an increased risk of implant failure and pseudarthrosis (non-union). The surgeon’s decision-making is critical. This review article will discuss the various studied surgical techniques and the evidence-based, accepted guidelines for managing patients with OVCF.

Posterolateral tibial plateau fracture

2025-12-23T09:21:33+07:00

Posterolateral tibial plateau fractures are relatively uncommon but are clinically significant due to their impact on knee stability and function. Accurate diagnosis, utilizing radiographic imaging and computed tomography (CT) scans, is essential for characterizing fracture patterns and planning appropriate treatment. Surgical management is considered the mainstay, with various approaches, including the anterolateral approach, posterolateral approach, and posteromedial approach, aimed at providing optimal access to fracture sites while minimizing soft tissue disruption. This article reviews the clinical features, optimal diagnostic methods, surgical strategies, and factors influencing treatment outcomes, such as the importance of anatomic reduction and postoperative rehabilitation. Proper surgical planning and selection of the most appropriate operative technique are critical to achieving optimal restoration of knee function and ensuring successful patient recovery.

Tumor-related pathologic fractures

2025-12-23T09:34:36+07:00

Pathologic fracture is most commonly caused by metastatic bone disease, which has become increasingly prevalent because advances in medical care have prolonged the survival of cancer patients long enough for bone metastasis to occur. Less common causes include primary bone tumors. Accurate diagnosis is a crucial determinant of treatment outcomes, since treating a pathologic fracture in the same manner as a traumatic fracture may result in reoperations and poorer outcomes. Therefore, thorough evaluation to identify the underlying pathology of the bone is necessary before initiating treatment. Management of pathologic fracture consists of conservative treatment, surgery, radiotherapy, and medical treatment. The goal of surgery is to restore patients’ ability to perform daily activities and to relieve pain. Surgical decisionmaking must consider disease factors, prognosis, as well as the location and size of the affected bone. Treating pathologic fracture is a challenge for orthopaedic surgeons, particularly those without subspecialty expertise in orthopaeadic oncology. When treatment limitations exist, referral to a hospital with a multidisciplinary team capable of providing comprehensive care is recommended.

Minimally invasive surgery technique inthoracolumbar injuries

2026-01-07T14:33:05+07:00

Thoracolumbar spinal injuries resulting from traumatic events remain a significant clinical challenge, with ongoing debate regarding the most effective treatment approaches. Management strategies include both non-operative and operative interventions, with surgical decision-making guided by neurological status and injury morphology. Historically, surgical treatment was performed via open posterior approaches; however, advancements in technique have introduced anterior and combined approaches, as well as the growing use of minimally invasive surgery (MIS). Surgical interventions are typically categorized into decompression, instrumentation, and spinal fusion, with selection based on injury type-such as compression, distraction, or translation injuries. The evolution of MIS has led to improved outcomes through reduced blood loss, lower infection rates, shorter hospitalization, faster recovery, decreased complication rates, and enhanced surgical precision. These advancements continue to shape current standards of care in the management of thoracolumbar spinal trauma.

Meniscus injury: 2025 update

2026-01-07T14:28:07+07:00

This topic focuses on medial meniscus posterior root tears, a condition that has garnered increasing attention due to its association with degenerative knee changes and the potential for early-onset osteoarthritis if left untreated. Biomechanically, a complete medial meniscus root tear mimics the effects of total meniscectomy, leading to impaired hoop stress distribution and accelerated cartilage degeneration. Early detection and accurate diagnosis are crucial for optimizing patient outcomes. Most cases of medial meniscus root tears occur in conjunction with degenerative changes of the knee, with meniscal extrusion being a common finding on magnetic resonance imaging, reflecting compromised meniscal function. Proper patient selection and a thorough understanding of the natural history of the disease are essential in guiding treatment decisions. Management options include conservative treatment, meniscectomy, meniscus root repair, meniscus reconstruction and techniques aimed at reducing meniscal extrusion. Long-term study suggest that surgical intervention, particularly meniscus root repair, is associated with a lower rate of knee replacement compared to nonoperative management.

Surgical management in chronic scapholunate ligament injury without arthritic change

2026-02-06T14:30:39+07:00

Scapholunate (SL) ligament injury represents the most common form of carpal instability and typically occurs following a fall onto an outstretched hand. Patients often present with dorsoradial wrist pain, swelling, or mechanical symptoms such as clicking on the affected side. Despite its prevalence, diagnosis in the acute phase can be challenging due to the nonspecific nature of early clinical findings and the frequently inconclusive appearance of initial radiographs. Although outpatient wrist arthroscopy may facilitate early diagnosis and treatment, its availability is generally limited to tertiary care centers. Delayed or missed diagnosis may lead to chronic wrist pain, progressive instability, and long-term functional impairment.

Several classification systems have been proposed for SL ligament injuries. This review focuses on static, reducible scapholunate ligament injuries without radiographic evidence of degenerative changes. According to contemporary practical management guidelines, these injuries correspond to stages III through V of the modified Garcia-Elias classification, reflecting increasing severity of ligamentous and capsuloligamentous disruption. These types of injuries are commonly encountered in patients whose symptoms have persisted for more than six weeks, representing the chronic phase of scapholunate ligament injury.

Surgical reconstruction remains the cornerstone of management for these lesions. However, no single operative technique has been universally accepted as the standard of care. The objective of this review is to synthesize the most current evidence and provide an educational summary of the available surgical options for treating static, reducible SL ligament injuries, with particular attention to reported clinical outcomes associated with each technique.

Premature physeal arrest, : A complication following a growth plate injury

2026-02-06T14:19:34+07:00

Physeal injuries are a common complication in pediatric trauma. While most cases resolve without consequence, a significant complication that can arise is premature physeal arrest, which results from the formation of a physeal bridge crossing the physis. Although this condition is relatively uncommon, it presents complex management challenges and, if left untreated, can lead to long-term morbidity such as limb length discrepancy and angular deformity. The primary pathophysiological process involves the development of a physeal bridge that disrupts normal bone growth. Early diagnosis is crucial and depends on careful patient follow-up after injury, supported by imaging modalities such as X-rays, CT scans, or MRI to assess the location and extent of the physeal bridge. Management strategies are tailored according to the size of the bar, the patient’s age, and the remaining growth potential. Treatment options include physeal bar resection, material transplantation, and, in cases of established deformity, corrective procedures such as osteotomy or limb lengthening. Thus this review aims to synthesize the current literature regarding the pathophysiology, diagnosis, and management strategies for premature physeal arrest following pediatric physeal injuries.

Deltoid ligament injuries: anatomy, biomechanics, and clinical implications

2026-02-06T14:25:05+07:00

Ankle joint stability is crucial for weight-bearing and movement in human locomotion, provided by the articulating bony structures and ligamentous support. The deltoid ligament is a fan-shaped, complex medial structure of the ankle joint, consisting of two layers—superficial and deep. It extends from the medial malleolus and inserts into the medial aspect of the talus, navicular, and calcaneus. The primary function of the deltoid ligament is to restrain abduction and external rotation forces, with specific parts of the ligament being affected depending on the mechanism of injury. Common injury mechanisms include excessive dorsiflexion, abduction, or external rotation, which can result in ligament rupture or avulsion fractures. While lateral ankle ligaments are more frequently injured, studied, and treated, medial ankle injuries account for approximately 5.0% - 15.0% of cases and are often associated with more severe conditions, such as ankle fractures or syndesmotic injuries. If left untreated or mismanaged, complications such as chronic ankle instability and post-traumatic osteoarthritis may develop. Given the lack of consensus regarding diagnosis and management, this review comprehensively examines the anatomy, biomechanics, mechanisms, and pathology of the deltoid ligament injury, drawing upon existing literature to enhance evidence-based treatment decisions and optimize long-term patient outcomes.

Dislocation after Total hip arthroplasty: A collective review

2026-02-06T14:38:03+07:00

Background: Total hip arthroplasty (THA) has proven to be a highly effective surgical procedure in improving patients’ quality of life. However, postoperative dislocation remains a concerning complication, affecting patient outcomes and increasing healthcare costs. Primary THA dislocation rates range between 1.0% - 2.0%, while revision THA carries a significantly higher risk, ranging from 5.0% - 30.0%. Understanding the causes, preventive measures, and management strategies for hip dislocation is crucial for optimizing surgical success and patient recovery.

Objective: To analyze the factors contributing to hip dislocation after THA, explore diagnostic methods, and review treatment strategies to improve surgical outcomes and reduce recurrence rates.

Methods: This literature review systematically compiles data on patient evaluations, including history-taking, physical examination, and radiographic assessments. It also classifies hip dislocation types, discusses associated risk factors, and outlines management strategies. Factors influencing dislocation risk—including confirmed contributors, potential associations, and disproven variables—are examined. Additionally, treatment approaches for recurrent dislocations and specialized prosthetic options designed for cases with unresolved instability are explored.

Results: Studies indicate various factors contribute to hip dislocation after THA, including spinopelvic alignment, prior hip surgery, revision surgery, surgical approach, soft tissue tension, implant positioning, neuromuscular conditions, head to neck ration, diagnosis of the index surgery and demographic data. Risk mitigation strategies include careful preoperative planning, appropriate implant selection, and rehabilitation protocols tailored to individual patient conditions. Evidence suggests that constrained liners and dual-mobility bearings significantly improve stability in high-risk cases, yet each option presents unique advantages and challenges requiring careful consideration.

Conclusion: Hip dislocation remains a significant concern following THA, particularly in revision procedures. A comprehensive approach involving thorough patient assessment, individualized surgical planning, and evidence-based treatment strategies is essential for reducing dislocation rates and optimizing patient outcomes. Future research should focus on developing patient-specific implants and surgical techniques to further enhance hip stability and long-term success.

Innovations in ACL reconstruction surgery

2026-02-06T14:42:42+07:00

Anterior cruciate ligament (ACL) is a crucial structure directly involved in knee function, including movement, walking, and running. An ACL injury can lead to abnormal knee function and potentially impact daily activities. Current treatments for ACL injuries include conservative treatment and physical therapy for mild cases. However, anterior cruciate ligament reconstruction surgery has become a widely used approach, incorporating advanced techniques to improve patient outcomes and quality of life. The objective of this article is to provide an overview of ACL reconstruction techniques, graft selection, and surgical outcomes, highlighting innovations that contribute to improved treatment efficacy.