Background: Cranio-maxillofacial (CMF) injuries represent a significant challenge in low- and middle-income countries (LMICs), exacerbated by inadequate infrastructure, resources, and training. This systematic review aims to evaluate the current strategies and solutions proposed in the literature to improve CMF fracture care in LMICs, focusing on education, patient transfer, and off-label solutions. Methods: A comprehensive literature search was conducted using PubMed/Medline from January 2000 to June 2023. Studies were selected based on the Preferred Reporting Items for Systematic Review and Meta-analysis Statement (PRISMA). Solutions were categorized into three main areas: education (digital and on-site teaching, fellowships abroad), patient transfer to specialized clinics, and off-label/non-operative solutions. Results: Twenty-three articles were included in the review, revealing a consensus on the necessity for enhanced education and training for local surgeons as the cornerstone for sustainable improvements in CMF care in LMICs. Digital platforms and on-site teaching were identified as key methods for delivering educational content. Furthermore, patient transfer to specialized national clinics and innovative off-label techniques were discussed as immediate solutions to provide quality care despite resource constraints. Conclusions: Effective CMF fracture care in LMICs requires a multifaceted approach, prioritizing the education and training of local healthcare professionals, facilitated patient transfer to specialized centers, and the adoption of off-label solutions to leverage available resources. Collaborative efforts between international organizations, local healthcare providers, and educational institutions are essential to implement these solutions effectively and improve patient outcomes in LMICs.

Purpose: The aim of this study was to analyze the injury patterns and clinical course of a winter sport dominated by blunt renal trauma collective. Methods: Blunt renal trauma cases (N = 106) treated in a Level 1 Trauma Center in Austria were analyzed. Results: We encountered 12.3% grade 1, 10.4% grade 2, 32.1% grade 3, 38.7% grade 4 and 6.6% grade 5 renal traumata classified according to the American Association for the Surgery of Trauma (AAST). The mechanisms of injury (MOI) did not have an influence on the frequency of HG trauma (i.e., grade 4 and 5). No concomitant injuries (CIs) were found in 57.9% of patients. The number of patients without CIs was significantly higher in the sports associated trauma group compared to other MOIs (p < 0.01). In 94.3% the primary treatment was a non-operative management (NOM) including 56.6% conservative, 34.0% endourological, and 3.8% interventional therapies. A follow-up computed tomography (FU-CT) was performed in 81.1%, 3.3 days after trauma. After FU-CT, the primary therapy was changed in 11.4% of cases (grade ≥ 3). Comparing the Hb loss between the patients with grade 3 and 4 kidney trauma with and without revision surgery, we find a significantly increased Hb loss within the first 96 h after the trauma in the group with a needed change of therapy (p < 0.0001). The overall rate of nephrectomy (primary or secondary) was 9.4%. Independent predictors of nephrectomy were HG trauma (p < 0.01), age (p < 0.05), and sex (p < 0.05). The probability of nephrectomy was lower with (winter) sports-associated trauma (p < 0.1). Conclusions: Sports-associated blunt renal trauma is more likely to occur isolated, and has a lower risk of severe outcomes, compared to other trauma mechanisms. NOM can successfully be performed in over 90% of all trauma grades.

A 75-year-old patient was transferred to the oncology department due to the discovery of a large pelvic tumor compressing the femoral neurovascular bundle suspected to be of malignant origin. Further investigation revealed a rare complication related to a 27-year-old total hip arthroplasty (THA). The final diagnosis was a severe adverse local tissue reaction (ALTR) resulting from excessive implant wear—first from a metal-on-metal (MoM) bearing and later exacerbated by a revision to a metal-on-polyethylene (MoP) articulation. The clinical course was further complicated by periprosthetic joint infection (PJI). The patient underwent extensive tumor-like mass resection followed by two-stage revision arthroplasty. Despite these interventions, infection persisted, ultimately necessitating joint resection. This case highlights the rare but serious convergence of dreaded orthopedic complications (ALTR and PJI). It underscores the diagnostic challenge posed by wear-induced pseudotumors, which are rare even among arthroplasty specialists and are often unfamiliar to oncologists. This case illustrates the importance of early orthopedic evaluation, maintaining a high index of suspicion in atypical presentations, and invites further discussion about the interplay between ALTRs and infection risk in arthroplasty patients.

Background: Patient-specific instrumentation (PSI) in total knee arthroplasty represents an increasingly relevant component of personalized surgical planning. As nearly half of orthopedic patients search online for medical information before or after clinical consultation, the quality, accuracy, and readability of publicly available digital resources directly influence patient expectations, shared decision-making, and rehabilitation engagement. This study assessed the content, quality, and readability of online information about PSI in TKA. Methods: Google searches using four predefined PSI-related terms were conducted on 6 March 2025. After applying exclusion criteria, 71 websites were included for evaluation. Websites were categorized as academic or non-academic and analyzed for authorship, reporting of advantages and disadvantages, inaccurate assertions, use of peer-reviewed references, multimedia content, and mention of specific PSI platforms. Website quality was assessed using validated quality evaluation tools (QUEST and JAMA criteria), and readability was evaluated using established readability indices (SMOG, FKGL, and FRE). Results: Academic websites demonstrated significantly higher quality than non-academic sources based on QUEST (25.4 vs. 9.8; p < 0.001) and JAMA criteria (3.7 vs. 1.7; p < 0.001). Disadvantages of PSI were reported in 69.1% of academic sites versus 12.5% of non-academic sites (p < 0.001). Inaccurate claims occurred in 31.3% of non-academic sites but were absent in academic sources (p < 0.001). Peer-reviewed references were present in 81.8% of academic websites and only 12.5% of non-academic sites (p < 0.001). Readability was uniformly poor across all websites, with no significant group differences (mean SMOG 13.5; mean FKGL 11.8; mean FRE 32.4). Conclusions: Online information about PSI in total knee arthroplasty varies widely in transparency and accuracy, with non-academic websites frequently omitting risks or presenting misleading claims. Given the role of individualized implant planning, accessible and evidence-based digital content is essential to support personalized patient education and shared decision-making. Because limited readability restricts patient comprehension and informed participation in personalized orthopedic care, improving the clarity and accessibility of digital patient resources is essential.