Background: The aim of this study is to compare the clinical and radiological outcomes of proximal femoral nailing performed in the lateral decubitus position between obese and non-obese patients. Methods: This retrospective cohort study, approved by the institutional ethics committee, included patients with acute AO/OTA classification types 31A1, 31A2, and 31A3 intertrochanteric femoral fractures treated with closed reduction and osteosynthesis using a short proximal femoral nail between 2022 and 2024. Obesity was defined as a body mass index of ≥ 30 kg/m ² . Patients were divided into obese and non-obese groups, and clinical, radiological, and complication outcomes were compared between the two groups. Results: A total of 533 patients were included, comprising 95 obese and 438 non-obese individuals. Obese patients were significantly younger and had higher Charlson Comorbidity Index scores ( p < 0.001). Operative time and intensive care unit admission rates were significantly higher in the obese group ( p < 0.001), and anesthesia type distribution differed between groups ( p < 0.001). Length of hospital stay and Harris Hip Scores were comparable ( p > 0.05). Radiologically, the distribution of tip–apex distance according to the 25-mm threshold did not differ between groups ( p = 0.244). However, optimal screw placement according to the Cleveland index was significantly less frequent in obese patients ( p < 0.001), and malposition in the lateral view was more common ( p < 0.001). Varus alignment and differences in reduction quality were also significantly associated with obesity status ( p < 0.001). Multivariable logistic regression analysis demonstrated that obesity remained an independent predictor of postoperative varus malalignment (OR 2.80, 95% CI 1.58–4.96; p < 0.001). Conclusion: Obesity negatively affects reduction quality and operative parameters during proximal femoral nailing for intertrochanteric femoral fractures performed in the lateral decubitus position, although acceptable reductions can generally still be achieved. Furthermore, obesity remained an independent predictor of postoperative varus malalignment after adjustment for potential confounding factors. Surgeons should be aware of these technical challenges when treating obese patients and consider them during preoperative planning and intraoperative reduction maneuvers.

The aim of this study was to investigate the relationship between anterior acromial extension beyond the clavicle and the presence of rotator cuff tears. Images of 1156 patients who underwent shoulder MRI examination due to shoulder pain were reviewed. Two groups were formed from 284 patients included in the study. Group 1 included 142 patients with anterior acromial extension beyond the clavicle, whereas Group 2 consisted of 142 patients without anterior acromial extension. The presence of a rotator cuff tear was recorded in all patients. The relationship between the size of the acromion's anterior extension and rotator cuff tear was statistically evaluated. In Group 1, the length of the anterior acromial extension was found to be an average of 7.7 mm (95% CI for median 6.8–8.5 mm). Anterior acromial extension was significantly associated with a higher incidence of rotator cuff tears compared with the control group (p < 0.001). Supraspinatus and subscapularis tears were more frequent in Group 1 (p = 0.020 and p = 0.011, respectively). During forward elevation, the contact between the acromion and the rotator cuff becomes more pronounced especially in cases with a prominent anterior acromial extension. This could potentially lead to inflammation in the rotator cuff, particularly in the supraspinatus and subscapularis muscles, and the method used in our study to measure anterior acromial coverage is relatively simple and reliable.

Background: This study evaluated whether routinely available admission hematologic and inflammatory markers remained associated with postoperative intensive care unit (ICU) admission and 1-month mortality when considered alongside established clinical and perioperative factors. Methods: We retrospectively analyzed 598 patients aged 65 years or older who underwent proximal femoral nailing (PFN) or hemiarthroplasty for hip fracture between October 2021 and October 2025. Admission laboratory values were obtained from the first blood tests at presentation. The primary outcome was 1-month mortality, and the secondary outcome was postoperative ICU admission. Group comparisons used the Mann–Whitney U and chi-square tests, and multivariable logistic regression was used for adjusted analyses. Given the limited number of deaths, the mortality analysis was considered exploratory. Results: Among 594 patients in the clinical ICU comparison, 228 (38.4%) were admitted to the ICU. One-month mortality occurred in 41 of 596 patients (6.9%). ICU admission was associated with age (OR 1.04, 95% CI 1.01–1.06), ASA score (OR 2.04, 95% CI 1.45–2.87), and number of packed red blood cell (PRBC) units transfused (OR 1.60, 95% CI 1.36–1.88). Mortality was associated with age (OR 1.07, 95% CI 1.02–1.12), male sex (OR 3.30, 95% CI 1.66–6.56), the fracture-treatment pathway represented by hemiarthroplasty versus PFN (OR 3.69, 95% CI 1.78–7.64), CRP per 10 mg/L (OR 1.05, 95% CI 1.01–1.10), and greater PRBC exposure (OR 1.37 per unit, 95% CI 1.11–1.70). RDW-CV was not associated with either outcome after adjustment. Conclusions: The observed associations with procedure and transfusion should not be interpreted as causal effects. Early outcomes were associated with multiple baseline, inflammatory, and perioperative factors, and the mortality findings remain exploratory and require confirmation in prospectively characterized cohorts.

Objective: The aim of this study was to evaluate temporal trends in public interest in common orthopedic conditions using online search data and to analyze changes over time, including the impact of the COVID-19 pandemic and seasonal variations.Materials and Methods: Public interest in orthopedic conditions was assessed using Google Trends. The search terms “hip fracture,” “knee replacement,” “meniscal tear,” “rotator cuff tear,” and “carpal tunnel syndrome” were analyzed. Data were collected worldwide between January 2015 and January 2026. Relative search volume (RSV) values were obtained and analyzed descriptively. Temporal trends, pandemic-related changes, and seasonal patterns were evaluated.Results: “Knee replacement” demonstrated the highest level of public interest and showed a clear increasing trend over time. “Carpal tunnel syndrome” maintained consistently high search interest with a mild upward trend. “Hip fracture” and “rotator cuff tear” exhibited relatively stable patterns with slight increases, whereas “meniscal tear” showed consistently low search volume throughout the study period. A marked decline in search interest was observed across all conditions during the early phase of the COVID-19 pandemic (March–April 2020), most prominently for “knee replacement.” Seasonal analysis showed small descriptive differences in RSV values across conditions; however, Wilcoxon signed-rank testing did not demonstrate statistically significant winter–summer differences for any search term.Conclusion: Public interest in orthopedic conditions has evolved over time, with increasing attention toward degenerative and surgical conditions. The COVID-19 pandemic had a marked temporary impact on search behavior. Although small descriptive seasonal differences were observed, these differences were not statistically significant and should be interpreted cautiously. Online search data may provide valuable insights into public awareness and healthcare trends.

Ejmi Eurasian Journal of Medical Investigation