This study provides a comprehensive examination of the current methodologies and potential strategies for the treatment of articular fractures of the foot. In the field of orthopedic healthcare, these fractures present a significant challenge due to their complex nature and the fact that they affect the routines of patients. The motivation behind this study is based on two main concepts. The first one is represented by the use of emerging medical technologies and personalized medicine to bring a significant transformation in the management of foot fractures and give a better quality of treatment that is accepted by the patient. However, because there are inequities in the availability of the necessary medical care and equipment, as well as uneven incorporation in clinical settings, new technologies cannot be used to treat these types of fractures. Regarding the second concept behind this study, it is indicated that although current treatment methods are essential, they have a number of shortcomings when it comes to properly addressing these types of injuries. An approach is needed that takes into account the biomechanical points of view and the particularities of each patient. This approach could be applied in all hospital settings. Through this study, we want to highlight the progress made in recent years in surgical techniques such as 3D printing, minimally invasive surgery (MIS), and biological products. However, in the application of this new discovery, new obstacles have been discovered that prevent the efficient treatment of these types of injuries. This study examines the effectiveness and limitations of current treatments, as well as how differences in healthcare, such as available equipment, training of medical staff, and technological advances, affect patient outcomes in everyday life. This research wishes to emphasize that continuous innovation, interdisciplinary collaboration, and the use of an optimal approach that is appropriate for each patient, are essential. This study aims to provide new insights and useful recommendations for future research and clinical practice. The main role of this research is to improve the quality of life of patients and increase the standards of care in this complex field, which is in permanent evolution.
Background: Jones fractures of the 5th metatarsal are frequently associated with nonunion due to limited vascularization and repetitive mechanical stress. The aim of the study was to compare the biomechanical performance of T-plate and bicortical screw fixation using standardized 3D models. Methods: Three-dimensional models of the 5th metatarsal were generated from CT images and printed using PolyJet technology (Stratasys J5 DentaJet) using a rigid-elastic composite with properties similar to cortical and cancellous bone. Jones fractures were fixed with either a locked T-plate or a bicortical screw. The samples were tested under axial and oblique static loads (α = 0°, 90°, 180°) and for three values of interfragmentary distance (d = 0.1–1 mm), in a 3 × 2 factorial design. Results: The T-plate fixation recorded a maximum yield force (Fmax) of 149.78 ± 8.53 N (138–161 N), significantly higher compared to the bicortical screw −98.56 ± 2.58 N (96–101 N), (p < 0.05). The ductility index was higher for the plate, indicating a progressive transition to yield. The α and d factors significantly influenced the mechanical behavior, with the polynomial model explaining over 95% of the total variation. Discussion: The plate fixation demonstrated greater strength and superior biomechanical tolerance in imperfect reduction scenarios. The main limitation is the lack of fatigue testing and the inability of 3D models to reproduce the structural heterogeneity of human bone. Conclusions: Implant selection should be individualized based on fracture stability. 3D models provide a reproducible platform for comparative evaluation of osteosynthesis methods, but future studies should include cyclic loading and biological validation.
Background/Objectives: Avulsion fractures of the fifth metatarsal often require surgical fixation when displacement or instability is present. This study aimed to compare the biomechanical performance of hook-plate and bicortical screw fixation using anatomically accurate 3D-printed metatarsal models analyzed through digital image correlation (DIC). Methods: Multi-material 3D-printed specimens were subjected to simulated gait-phase loading (α = 0°, 90°, 180°), combined with three interfragmentary distances (d = 0.1, 0.5, 1 mm) following a replicated 3 × 3 factorial design (n = 27 per fixation method). Full-field strain and displacement maps were quantified using ARAMIS DIC. Results: Hook-plate fixation consistently produced lower maximum stresses compared with bicortical screws (reductions of 9–36 MPa across conditions). The highest stresses were observed for screw fixation at α = 90° and d = 0.1 mm (100.3 ± 1.5 MPa), while the lowest occurred for hook plates at α = 180° and d = 1 mm (33.3 ± 1.5 MPa). ANOVA confirmed significant α×d interactions (p < 0.01). Conclusions: Hook-plate fixation provided superior angular stability and suggested improved cyclic performance compared to bicortical screws, favoring early mobilization. The combined use of 3D printing and DIC represents a valuable framework for preclinical implant evaluation. These results provide useful insights for selecting the optimal fixation technique in clinical management of fifth metatarsal avulsion fractures.
Background. In the last decade, it was concluded that glaucomatous optic neuropathy is part of the neurodegenerative diseases in which destructive neuronal lesions are located not only in the structure of the retina, but they are also present at the level of the central visual and nervous pathways. Patients with Primitive Open Angle Glaucoma may have experienced changes such as sensorineural hearing loss as well as balance changes. The purpose of this study is to evaluate the degree of involvement of the auditory system in patients with glaucoma, the structural changes in the optic nerve and, to establish correlation between the hearing loss and structural changes in the optic nerve. The subjects included in the study are grouped as follows: a group of patients with glaucoma that will be compared to a group of patients without glaucoma only as well as identi-fy-ing the evolution of structural changes in optic nerve to patients with glaucoma and to normal patients. Material and methods. It is a prospective, cross-sectional study on 32 eyes of 16 subjects with Primitive Open Angle Glaucoma in a study group and 24 eyes of 12 healthy subjects in con-trol group with a mean age of 62 years in both groups. Both groups underwent ophthalmo-logical, audiological and radio imaging evaluation: Pure-tone audiometry (PTA) were recorded, oph-thalmologic evaluations according to a standardized protocol and MRI cerebral examination was performed. Results: In the Study group patients, compared to the Control group, the average lev-els of the left PTA, the cup/disc (C/D) area in both eyes, the C/D ratio in both eyes are in-creased. The mean level of Retinal nerve fiber layer (RNFL) mean thickness was slightly lower in patients with glaucoma. Multivariate analysis demonstrates that gender can be a good predictor of C/D area, gender and age can be good predictors of PTA both eyes and C/D ratio in the right eye, and gender, age and background can be good predictors of disc area in the left eye. Conclu-sions: Pa-tients with Primitive Open Angle Glaucoma show changes in audiometry test in correla-tion with ophthalmological parameters demonstrating that the auditory system can be affected in Primitive Open Angle Glaucoma. This study emphasizes the problem of interdisciplinarity in medicine with the aim of ensuring the quality of life of patients with glaucoma. A good collabora-tion between ophthalmologist and otolaryngologist will be very useful for these patients.