New research in orthopaedic trauma is discussed in the latest JBJS Specialty Update, What’s New in Orthopaedic Trauma. Here, we highlight the 5 most notable studies, as selected by coauthor Brendan M. Patterson, MD.
Shoulder Girdle
Researchers performed a network meta-analysis to determine the optimal combination of surgical technique and rehabilitation protocol for the treatment of complex proximal humeral fractures in older adults. Twenty-eight studies (1,119 patients with a mean age of 74 ± 3.7 years) were reviewed. Reverse total shoulder arthroplasty with a cementless stem and early initiation of range of motion was found to produce the best outcomes1.
Hip and Femur
A study published in JBJS investigated factors associated with nonunion in 560 patients with a distal femoral fracture treated with lateral locked plating. Reoperation for nonunion was performed in 9.6% of patients. Multifragmentary comminution of the metaphysis, medial cortical comminution, varus or valgus malalignment, and obesity increased the odds of nonunion2.
Tibia and Ankle
A Level 1 randomized multicenter trial published in JBJS compared immediate weight-bearing in a boot with non-weight-bearing with a cast following open reduction and internal fixation of ankle fractures. Each group had 80 participants. The primary outcome, the Olerud-Molander Ankle Score at 6 weeks, was better in the weight-bearing group than in the non-weight-bearing group3.
In a Level 1 randomized trial of 30 patients with pilon injuries, direct reduction and fixation of the posterior column using posterior buttress plating was compared with indirect reduction and fixation using anterior-to-posterior (AP) screws. The percentage of patients who achieved anatomical reduction, the primary outcome, was higher in the posterior buttress plating group (80% vs. 26.7%)4.
Fracture-Related Infection
The effectiveness of oral vs. intravenous antibiotics in treating fracture-related infections was evaluated in a randomized multicenter trial that included 233 patients. The total number of surgical interventions in the oral antibiotic group was noninferior to that in the intravenous group in the as-treated analysis. However, this finding was not supported in the secondary per-protocol analysis5.
What’s New in Orthopaedic Trauma is freely available at JBJS.org.
What’s New by Subspecialty
Each month, JBJS publishes a review of the most pertinent studies from the orthopaedic literature in a select subspecialty. To read the reports, visit the What’s New by Subspecialty collection at JBJS.org.
Recent OrthoBuzz posts include: What’s New in Spine Surgery, What’s New in Sports Medicine, and What’s New in Foot and Ankle Surgery.
References
- Colasanti CA, Anil U, Rodriguez K, Levin JM, Leucht P, Simovitch RW, Zuckerman JD. Optimal combination of arthroplasty type, fixation method, and postoperative rehabilitation protocol for complex proximal humerus fractures in the elderly: a network meta-analysis. J Shoulder Elbow Surg. 2024 Oct;33(10):e559-74.
- Wagner RK, Janssen SJ, Cote M, Borgida JS, Tung WS, Kloen P, Weaver MJ, Harris MB, Aneja A, Ly TV; Distal Femur Research Group. Risk factors for nonunion following lateral locked plating of distal femoral fractures: a Bayesian analysis of 560 patients. J Bone Joint Surg Am. 2026 Feb 4;108(3):235-43.
- Khojaly R, Rowan FE, Shah V, Nagle M, Shahab M, Ahmad AS, Dahly D, Taylor C, Niocaill RM, Cleary M. Immediate weight-bearing compared with non-weight-bearing after operative ankle fracture fixation: results of the INWN pragmatic, randomized, multicenter trial. J Bone Joint Surg Am. 2025 May 23;107(13):1423-38.
- Baraka MM, Fayyad TA, Thakeb MF, Lamei MA, Al Kersh MA. Posterior plating versus anterior to posterior screws in fixation of posterior column in pilon fractures. J Orthop Trauma. 2025 Jun 1;39(6):288-95.
- Obremskey WT, O’Toole RV, Morshed S, Tornetta P 3rd, Murray CK, Jones CB, Scharfstein DO, Taylor TJ, Carlini AR, DeSanto JM, Castillo RC, Bosse MJ, Karunakar MA, Seymour RB, Sims SH, Weinrib DA, Churchill C, Carroll EA, Pilson HT, Goodman JB, Holden MB, Miller AN, Sietsema DL, Stahel PF, Mir H, Schmidt AH, Westberg JR, Mullis B, Shively KD, Hymes RA, Konda SR, Vallier HA, Breslin MA, Smith CS, Crickard CV, Reid JS, Baker M, Eglseder WA, LeBrun C, Manson T, Mascarenhas DC, Nascone J, Pollak AN, Schloss MG, Sciadini MF, Degani Y, Miclau T, Weiss DB, Yarboro SR, McVey ED, Firoozabadi R, Agel J, Burgos EJ, Gajari V, Rodriguez-Buitrago A, Tummuru RR, Trochez KM; Major Extremity Trauma Research Consortium (METRC). Oral vs intravenous antibiotics for fracture-related infections: the POvIV randomized clinical trial. JAMA Surg. 2025 Mar 1;160(3):276-84.