Orthopedic Surgery

Portal messaging surged nearly 400% and is concentrated among surgical shoulder/elbow patients

In 23,643 shoulder and elbow patients, 21% sent ≥1 medical advice message and medical advice comprised 30% (41,542 of 137,960) of messages. Medical-advice message volume grew nearly 400% from 2022 to 2026, indicating rapidly rising outpatient electronic workload. Surgical patients were far more engaged with portals (aOR 5.93; aIRR 23.3) than non-surgical patients. Black race and Spanish language independently predicted lower portal use, suggesting portal design or access gaps may worsen disparities. 1

Delays and transfers predict higher 14-day mortality after orthopaedic trauma in Tanzania

Among 7,121 consecutive orthopaedic trauma patients, 14-day mortality was 10.8%, higher for open fractures (16.4%). Independent predictors of 14-day death included interfacility transfer (aOR 1.99), rural residence (aOR 1.80), and prolonged prehospital delay (aOR 1.39). Timely surgery was associated with lower mortality (aOR 0.87), supporting expedited operative access. Complications occurred in 22.2% of surgical patients, chiefly surgical site infections, underscoring infection control importance. 2

EAST-BMS: an East Asian machine-learning survival model for nonspinal bone metastasis surgery

The authors developed EAST-BMS using 1,045 patients undergoing surgery for nonspinal bone metastases across Korea, Taiwan, and Japan. EAST-BMS showed discrimination comparable to the SORG model and demonstrated potential clinical utility in decision-making. Key predictive variables included albumin, Karnofsky performance status, lymphocyte percentage, and CRP. This is an internal multinational evaluation; external validation is required before routine clinical adoption. 3