Background and Objectives: Iron-deficiency anemia (IDA) could predispose the afflicted individuals to various infections and musculoskeletal disorders. This study attempted to investigate the association between IDA and septic arthritis (SA), a musculoskeletal disease. Materials and Methods: We investigated all the eligible subjects in the Taiwanese longitudinal health insurance database (LHID) between 2000 and 2012. Subjects with the diagnosis of IDA (International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM): 280) were allocated to the IDA cohort. The control subjects were randomly matched to every subject with IDA coding by age and sex at the 1:4 ratio. All of the recruited subjects were followed since the index date to the onset of SA (ICD-9-CM: 711.0), withdrawal from the insurance (including death), or 31 December 2013. Results: The cumulative incidence of SA was assessed. We showed that the cumulative incidence of SA was higher in the IDA cohort than in the control cohort (p-value < 0.0001). After adjustment of the comorbidities, the IDA patients had a 2.53-fold risk of SA compared to control subjects (aHR = 2.53, 95% CI = 1.89–3.38). Conclusions: IDA was associated with an increased risk of SA.

Study design: Retrospective cohort study. Objective: To analyze the efficacy and safety of Halo-femoral traction (HFT) following spinal release, and preoperative Halo-gravity traction (HGT) in patients with severe spinal kyphoscoliosis and spinal cord risk classification (SCRC) type 3 at the apex. Methods: A total of 73 patients (24 males, 49 females, mean age 22.4 ± 6.4 years) and 56 patients (15 males, 41 females, mean age 22.9 ± 10.4 years) were included in the HFT and HGT group, respectively. Radiographic parameters were measured at the initial assessment, post-traction, post-final surgery, and during each follow-up. Neurologic function was assessed using the Frankel score system. IONM alerts and all complications were documented. Quality-of-life was evaluated using the SF-36 questionnaire. Results: In the HFT vs HGT group, the total correction rates were 39.9 ± 7.2% v.s. 41.3 ± 6.8% for the major Cobb and 36.6 ± 9.3% v.s. 44.4 ± 9.2% for global kyphosis (GK) after final surgery, respectively. The traction contributions were 57.6 ± 11.1% v.s. 52.3 ± 9.3% for major Cobb and 70.1 ± 10.5% v.s. 63.9 ± 11.1% for global kyphosis (GK), respectively. More than half of the total correction can be achieved gradually and safely through preoperative traction with patients in an awake state. No deterioration in neurological function was found post-final surgery. During the last follow-up, SF-36 questionnaire scores improved significantly in both groups ( P < .05). Conclusions: Significant outcomes can be expected in patients with severe kyphoscoliosis, even with spinal cord risk classification (SCRC) type 3 at the apex undergoing HFT and HGT.

Background: Hallux valgus is a common forefoot disorder with hundreds of proposed management techniques. Distal chevron osteotomy with a modified McBride procedure has been traditionally recommended for mild hallux valgus because of its simple and less invasive nature with fewer complications, faster recovery, and reliable outcomes. In recent years, the indications for this procedure have expanded to include hallux valgus with severe deformities. This study aims to compare the radiographic outcomes of the surgical treatment for moderate versus severe hallux valgus patients from the perspective of sesamoid bone reduction. Materials and Methods: A retrospective review of medical records identified 99 feet from 94 patients that were treated with distal chevron osteotomy with a modified McBride procedure. These feet were divided by the preoperative hallux valgus angle and intermetatarsal angle into the moderate and severe groups. Results: Postoperative radiographic parameters significantly improved in both groups after treatment, indicating adequate deformity correction. Improvement in the sesamoid position was better in the moderate group compared to that in the severe group. The recurrence rate in the severe group was higher than that in the moderate group without statistical significance. Conclusions: Based on the radiographic results of the postoperative position following sesamoid reduction, the distal chevron osteotomy with a modified McBride procedure is effective for treating moderate hallux valgus deformities. However, this treatment strategy may be associated with a higher recurrence rate in cases of severe hallux valgus deformity. A complete reduction in the sesamoids should be emphasized during the management of severe hallux valgus deformity.

Study Design: Retrospective cohort study. Objective: Reciprocal changes (RCs) in unfused spinal segments can significantly affect the global alignment after corrective surgery. Identifying radiographic thresholds for guiding surgical strategies is critical for optimizing the outcomes. Materials and Methods: Ninety-eight ASD patients who underwent staged surgeries, including lateral lumbar interbody fusion (LLIF) and posterior spinal fusion (PSF), were analyzed. According to the final follow-up image, the patients were classified into balanced (BG) and imbalanced (IG) groups, with IG further stratified into proximal junctional kyphosis/failure (IG-PJK/PJF) and non-PJK/PJF (IG-NPJK/PJF). Radiographic and clinical data were collected preoperatively, postoperatively, and at 2-year follow-up. Results: The IG exhibited greater RCs in thoracic kyphosis (TK) and PI-LL mismatch from postoperative to follow-up than the BG ( P = .030, P = .008). Significant predictors included Age >65.5 y/o (AUC: .672) and Post-PT >17.5° (AUC: .852) for imbalance and Post-TK >34.5° (AUC: .755) for IG-PJK/PJF. IG-PJK/PJF showed poorer ODI scores than BG and IG-NPJK/PJF ( P = .021 and P = .022, respectively). IG-PJK/PJF showed poorer total SRS-22 scores than IG-NPJK/PJF ( P = .021). Conclusion: Increased RCs in TK was associated with adverse outcomes. Extending the upper instrumented vertebra (UIV) to the upper thoracic spine and addressing excessive TK (>34.5°) may improve alignment and reduce complications. Radiographic thresholds can provide actionable guidance in surgical planning.