30-Second Takeaway
- Add remplissage to Bankart repair for on-track Hill-Sachs lesions to markedly cut recurrence with similar function and complications.
- Apply the new two-type fifth metatarsal base fracture system to better flag unstable, nonunion-prone injuries for fixation.
- Favor early rib fixation in older adults to reduce ICU stay, ventilation duration, and pulmonary complications.
Week ending January 31, 2026
Targeted updates in shoulder reconstruction, limb salvage, and trauma care with direct implications for fixation, revision strategy, and prognosis
Bankart plus remplissage cuts recurrence for on-track Hill-Sachs lesions
This systematic review pooled nine studies with 1006 patients undergoing Bankart repair with or without remplissage for on-track/non-engaging Hill-Sachs lesions. Compared with Bankart alone, Bankart-remplissage had markedly lower recurrent instability, redislocation, and revision rates, with relative risks roughly 2–3 favoring remplissage. Return-to-sport was higher with remplissage, and WOSI and Rowe scores modestly favored remplissage, while other PROs were similar between groups. One of three studies showed slightly better range of motion with isolated Bankart, but apprehension was substantially more frequent without remplissage.
Two-type fifth metatarsal base fracture system links anatomy to stability
This study proposes a two-category classification of fifth metatarsal base fractures derived from peroneus brevis footprint anatomy and loading mechanics. Fractures within the peroneus brevis footprint are labeled avulsion injuries and were biomechanically stable in cadaver testing under tendon loading. Fractures distal to the footprint are labeled indirect injuries from bending forces and behaved as unstable patterns in simulation. The authors report higher interobserver and intraobserver reliability than the three-type Lawrence–Botte system and clearer treatment implications.
Early rib fixation improves resource use and complications in geriatric trauma
This NTDB analysis included 5129 patients aged 65 years or older who underwent surgical stabilization of rib fractures from 2018 to 2022. Early fixation within 72 hours, performed in about 60% of patients, was associated with shorter hospital and ICU stays and shorter ventilation duration than late fixation. Unplanned intubation, tracheostomy, ARDS, and pneumonia were all less frequent after early surgery, while mortality remained similar between groups. Multivariable modeling confirmed that late fixation independently increased hospital stay, ICU stay, and ventilator days.
References
Numbered in order of appearance. Click any reference to view details.
Additional Reads
Optional additional studies from this edition.