Lee WY, et al. Clin Orthop Surg. 2021 Sep;13(3):293-300. https://doi.org/10.4055/cios20212

Background and Objectives: This study investigated associated meniscus and ligament injuries in tibial plateau fractures using magnetic resonance imaging (MRI) and assessed soft tissue injuries in relation to the Schatzker classification and Tscherne classification. Materials and Methods: The data of 185 patients who sustained tibial plateau fractures from January 2010 to April 2021 were retrospectively reviewed. Fractures were classified according to the Schatzker classification system. Soft-tissue injuries were assessed using the Tscherne classification. Menisci and ligaments were evaluated using preoperative MRI. Nerve injuries, compartment syndrome and wound problems were also assessed. The incidence of soft tissue injuries, as well as the relationship between the Schatzker and Tscherne classification systems, were analyzed. Results: Evidence of derangement of meniscus and ligament around the knee was found in 183 (98.9%) patients. The most common injury was a medial collateral ligament injury. The incidence of lateral collateral ligament injury, nerve injury, compartment syndrome and wound problem was higher in high-energy tibial plateau fractures. A tendency was observed between the Schatzker and the Tscherne classifications (p value < 0.001). Higher Tscherne grade was also associated with the incidence of posterior cruciate ligament injury, nerve injury and compartment syndrome. Conclusions: In tibial plateau fractures, soft tissue injuries were highly prevalent. High-energy fractures tended to exhibit higher Tscherne classification grades and showed an increased incidence of meniscus and ligament injuries. The Tscherne classification appears to be a helpful system for predicting soft tissue injuries in tibial plateau fractures. And preoperative MRI can be a helpful tool.

윤자영, et al. J Korean Soc Spine Surg. 2026 Sep;33(3):76-86. https://doi.org/10.4184/jkss.2026.33.3.76

Background: Parents increasingly rely on the internet for health-related information about their children; however, the quality of such information remains inconsistent. Pediatric flatfoot is a common parental concern in pediatric orthopedics. This study compared the quality of NAVER-retrieved Korean-language websites and Google-retrieved English-language websites on pediatric flatfoot using the Ensuring Quality Information for Patients (EQIP) tool.Methods: Websites related to pediatric flatfoot were searched using NAVER for Korean-language information and Google for English- language information. After applying the predefined exclusion criteria, 50 websites from each group were evaluated using the 36-item EQIP tool, which assesses content, identification, and structure. Total and domain scores were compared between the two groups and according to institution type.Results: Google-retrieved English-language websites had significantly higher total EQIP scores than NAVER-retrieved Korean-language websites (55.50±10.17 vs. 44.88±11.83, p<0.001), with higher content and structure scores but similar identification scores. Among NAVER-retrieved Korean-language websites, public institution websites had higher total EQIP scores than private websites (55.38±8.69 vs. 39.95±9.74, p<0.001), mainly owing to higher content scores. Among the top 10 search results in each group, Google- retrieved English-language websites had higher EQIP scores and included more public institution websites than NAVER-retrieved Korean-language websites.Conclusion: In the selected search environment, Google-retrieved English-language websites had higher EQIP scores than NAVER-retrieved Korean-language websites. Among the NAVER-retrieved Korean-language websites, public institution websites provided higher- quality information than private websites, but their visibility in the NAVER search results was limited. Improving the quality and visibility of reliable Korean online resources may support informed parental decision-making.

Background: Biportal endoscopic transforaminal lumbar interbody fusion (BESS-TLIF) is an emerging minimally invasive technique. This study aimed to evaluate the two-year radiological fusion outcomes of single-level BESS-TLIF using a specific banana-shaped, porous titanium interbody cage. Methods: This retrospective study reviewed 51 patients who underwent the specified procedure. The primary endpoint was the radiological fusion rate, assessed by computed tomography (CT) over 24 months using a three-grade system. Factors influencing fusion, particularly bone graft composition (demineralized bone matrix [DBM] only vs. DBM with I-factor), were also analyzed. Results: The final complete fusion rate at two years was 96.1% (49/51; 95% Confidence Interval (CI), 86.5–99.5%). Bony fusion occurred predominantly in the posterior and intracage regions. The only significant factor influencing fusion was the bone graft material. The ‘DBM with I-factor’ group achieved complete fusion significantly faster than the ‘DBM only’ group (log-rank test, p < 0.001), with a higher final fusion rate (100% vs. 83.3%, p = 0.045). Conclusions: Single-level BESS-TLIF using a banana-shaped, porous titanium cage provides favourable two-year radiological fusion rates. The selective addition of I-factor as an osteoinductive supplement can significantly accelerate the time to achieve solid arthrodesis.

Background and Objectives: The optimal pharmacological strategy to mitigate progressive vertebral collapse during the acute phase of osteoporotic vertebral compression fractures (OVCFs) remains a subject of debate. This initial 3-month window is the most critical period for evaluating the structural stability of the fracture, as the majority of progressive height loss occurs before solid bone union is achieved, directly influencing the decision to continue conservative management or transition to surgical intervention. Materials and Methods: In this retrospective study, 123 patients were allocated to control (n = 26), denosumab (n = 35), teriparatide (n = 30), or romosozumab (n = 32) groups. Treatment choice was non-randomized, driven by clinical pragmatism and patient preference. Serial changes in vertebral compression rate (VCR) and pain (VAS) were analyzed over 3 months using linear mixed models (LMMs) specifically adjusted for baseline imbalances in initial VCR. Results: In the unadjusted analysis, DMAB appeared to show a slower progression of compression compared to the control group. However, after adjusting for the initial VCR, no significant structural benefit was observed in any medication group (p > 0.05), with all groups showing small effect sizes (Cohen’s d < 0.4). In contrast, unstable fracture morphology was identified as the most potent driver of vertebral collapse (β = 2.758, 95% CI: 1.51–4.01, p < 0.001). Clinically, the RM group showed significantly lower overall pain levels throughout the follow-up period compared to the control group (p = 0.014). Conclusions: Short-term osteoporosis medication does not significantly mitigate vertebral collapse during the acute phase of OVCFs. Practically, these findings suggest that unstable fracture morphology and the baseline VCR—reflecting a potential ‘floor effect’ where less initially collapsed vertebrae may undergo more significant progression—are more informative predictors of acute collapse than medication choice. Consequently, early imaging-based risk stratification is crucial to identify patients at high risk for progressive deformity, regardless of their pharmacological regimen.