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Open research questions in Orthopedic Surgery and Rehabilitation

148 unresolved questions extracted from the limitations and future-work sections of 541 Orthopedic Surgery and Rehabilitation papers in our library. Each links back to the study that raised it.

What the literature leaves open

  • Retrospective study, - Small sample size, - Significant age difference between groups, - Lack of randomization, - Need for prospective randomized studies

    Single vs double headless compression screw fixation for scaphoid nonunion · 2026 · DOI

  • Prospective randomized studies with larger sample sizes, - Studies to confirm the functional advantage of double-screw fixation, - Research on the optimal fixation method for scaphoid nonunion

    Single vs double headless compression screw fixation for scaphoid nonunion · 2026 · DOI

  • Postoperative rehabilitation protocols remain heterogeneous, and validated criteria for progression and return to work or sport are lacking.

    CONTEMPORARY IMAGING, ARTHROSCOPIC REPAIR, AND FUNCTIONAL REHABILITATION IN TRAUMATIC TRIANGULAR FIBROCARTILAGE COMPLEX TEARS: A NARRATIVE REVIEW · 2026 · DOI

  • Future research should focus on standardized diagnostic pathways, comparative evaluation of repair techniques, objective functional monitoring, and patient-centered return-to-activity outcomes.

    CONTEMPORARY IMAGING, ARTHROSCOPIC REPAIR, AND FUNCTIONAL REHABILITATION IN TRAUMATIC TRIANGULAR FIBROCARTILAGE COMPLEX TEARS: A NARRATIVE REVIEW · 2026 · DOI

  • Background Although open trigger finger release is widely regarded as a safe and effective procedure, existing literature primarily focuses on younger populations, with limited evidence addressing outcomes in nonagenarian patients.

    Safety and Complications of Open Trigger Finger Release in Patients Over 90 Years Old: A Retrospective Analysis · 2026 · DOI

  • There is a need to compare the cost-effectiveness of different treatment strategies for DRF.

    Comparative cost-effectiveness analysis of different treatment strategies for distal radius fracture · 2026 · DOI

  • The comparative efficacy and safety of haematoma block and procedural sedation for manipulating distal radius fractures are uncertain. There is a lack of high-quality evidence comparing haematoma block with procedural sedation.

    Haematoma block versus sedation for manipulating distal radius fractures in the emergency department · 2026 · DOI

  • Delayed primary repair (DPR) of flexor tendon injuries can be challenging due to the limited time frame for intervention. Measuring tendon gap by ultrasound can be difficult. Treatment decisions can be complex and require careful consideration of multiple factors.

    The correlation between tendon gap measurement by ultrasound and management of flexor tendon injury zone 1, 2, and 3 · 2026 · DOI

  • The time frame for delayed primary repair (DPR) of flexor tendon injuries remains debatable. There is a lack of understanding of the correlation between tendon gap measurement by ultrasound and management of flexor tendon injury.

    The correlation between tendon gap measurement by ultrasound and management of flexor tendon injury zone 1, 2, and 3 · 2026 · DOI

  • Traditional surgical management may not be effective in cases with compromised vascularity or failed prior fixation. There is a need for alternative fixation strategies that can provide sufficient stability to support graft incorporation.

    Pedicled distal-radius vascularized bone graft with shape-memory staple fixation for scaphoid nonunion: A modified technique · 2026 · DOI

  • The diagnosis of volar DRUJ dislocation can be easily missed due to subtle clinical findings. There is a lack of reported cases of volar DRUJ dislocation associated with an ulnar styloid fracture.

    Volar Distal Radioulnar Joint Dislocation With Ulnar Styloid Fracture · 2026 · DOI

  • There is a lack of studies on the incidence of ACL injuries among athletes in Saudi Arabia. There is a need to evaluate the effectiveness of MRI in diagnosing ACL tears among athletes.

    The Precision of MRI in the Diagnosis of Anterior Cruciate Ligament Injury Among Athletes in Riyadh, Kingdom of Saudi Arabia · 2026 · DOI

  • Current treatments for SLAC and SNAC stage II have limitations and complications. There is a need for alternative techniques that can improve patient outcomes.

    Scaphoidectomy and Midcarpal Tenodesis is a Valid Alternative to Midcarpal Arthrodesis and Proximal Row Carpectomy for SLAC and SNAC Stage II · 2026 · DOI

  • The study only included nonrandomized studies. The sample size was limited to 593 patients. The follow-up period was ≥ 6 months, but the exact duration was not specified.

    Autologous Lunate Replacement in Kienbock’s: Systematic Review and Meta-Analysis · 2026 · DOI

  • There is a lack of comprehensive reviews on autologous lunate replacement for Kienböck's disease. The current literature is limited to small-scale studies with varying outcomes.

    Autologous Lunate Replacement in Kienbock’s: Systematic Review and Meta-Analysis · 2026 · DOI

  • Further studies can investigate the long-term effects of tendon repair timing on anxiety and functional outcomes. Research can explore the underlying mechanisms of the relationship between tendon repair timing and anxiety.

    Tendon Repair Within 6 Hours After Injury in Zone 2B is Associated With Higher Anxiety But Similar Functional Outcomes · 2026 · DOI

  • The accuracy of surgeons' predictions for treatment outcomes of distal radius fractures is unknown. There is a need to understand the factors influencing surgeons' choices between surgical and conservative treatment. The study aims to address this gap by investigating surgeon preferences and outcome predictions.

    Surgeon Preferences and Outcome Predictions for Displaced Distal Radius Fractures in Elderly Patients: A Survey of 151 Surgeons Making 4,832 Treatment Predictions Based on Patient Profiles and Radiographs · 2026 · DOI

  • A major strength of this study is the use of real patient data derived from a randomized clinical trial. This allowed us to avoid constructing hypothetical cases and instead base our findings on actual clinical scenarios. Furthermore, we deliberately selected the best- and worst-performing patients from each treatment group (ORIF and casting) to create maximum contrast between profiles with good and poor outcomes. We believe that this approach, maximizing the difference in outcome extremes, should facilitate the decision-making process. If surgeons are unable to accurately predict outcomes in such clearly contrasting cases, it is even less likely that they would succeed in predicting more subtle variations in clinical outcomes. Several limitations of the study should also be acknowledged. First, the survey included an equal number of profiles with good and poor outcomes (four for each treatment), which does not reflect typical clinical practice where the majority of patients tend to have favorable outcomes. This artificial balance may have affected participants’ expectations and decisionmaking. Second, the outcome predictions were based on PRWE scores, which are difficult to estimate based solely on written patient information and radiographs. As discussed earlier, radiographic findings are known to correlate poorly with final functional outcomes. Moreover, translating a real clinical presentation into a numerical PRWE estimate over a 1-year period is probably very challenging for any clinician. Third, the study is subject to potential selection bias. The relatively high proportion of hand surgeons among respondents (47.9%) may not accurately reflect the broader population of surgeons treating distal radius fractures and could influence generalizability. It is however unlikely that the broader population of surgeons would be better in estimating treatment outcomes. Fourth, complications can have a substantial impact on treatment outcomes and are often difficult to predict. In our study, complications were present in three of the selected patient profiles. For two of the surgically treated patients with poor outcomes a complication was registered. One required surgical denervation of the posterior interosseous nerve because of persistent pain, which may not be considered a complication since it is a results of symptoms rather than a cause. Another underwent hardware removal because of severe dorsal redisplacement in spite of surgical fixation which resulted in the flexor tendons contacting the volar plate.

    Surgeon Preferences and Outcome Predictions for Displaced Distal Radius Fractures in Elderly Patients: A Survey of 151 Surgeons Making 4,832 Treatment Predictions Based on Patient Profiles and Radiographs · 2026 · DOI

  • Precise targeting of the pulley is challenging with non-guided injections. Trigger finger can be a debilitating condition, affecting hand function and quality of life. Current treatments may have limited effectiveness or significant side effects.

    Trigger finger: US guided combined dry needling and steroid injection provides better long term results than non-guided steroid injection · 2026 · DOI

  • The study had a small sample size of 30 patients. The study did not report any significant adverse events, but this may be due to the small sample size. The study did not compare the effectiveness of US-guided dry needling and corticosteroid injection to other treatments such as surgical release.

    Trigger finger: US guided combined dry needling and steroid injection provides better long term results than non-guided steroid injection · 2026 · DOI

  • Maintaining reduction during follow-up can be difficult, especially in patients who initially receive non-operative management. Deciding whether to proceed with surgical intervention remains controversial. There is no consensus on the optimal treatment strategy for AO/OTA type 23-C1 and C2 fractures.

    Surgical Versus Conservative Treatment for Intra‐Articular Distal Radius Fractures With Loss of Reduction in Elderly Patients · 2026 · DOI

  • There is no consensus on the optimal treatment strategy for AO/OTA type 23-C1 and C2 fractures. The study aims to address this gap by comparing the clinical and radiological outcomes of surgical versus conservative treatment in elderly patients with these types of fractures.

    Surgical Versus Conservative Treatment for Intra‐Articular Distal Radius Fractures With Loss of Reduction in Elderly Patients · 2026 · DOI

  • There is a growing interest in nonoperative treatments using intravenous (IV) antibiotics to reduce surgical complications. The current study aims to fill the gap by characterizing national trends in the operative management of APFT.

    Trends in the Management of Acute Pyogenic Flexor Tenosynovitis of the Hand: A Comprehensive Analysis · 2026 · DOI

  • As with a majority of studies analyzing deidentified aggregate data from a large database, researchers are restricted to a limited subset of information on each patient. For example, this presents a barrier to further evaluating the cause or introduction of an infection. With additional information, such as a patient’s history of present illness or physical exam findings, this might provide further insight regarding independent risk factors or the cause of infection. Another limitation to utilizing large retrospective patient databases is that the data recorded does not allow the researcher to perform granular analyses. For instance, this conglomerate database does not provide further details regarding the severity of infection or a surgeon's threshold to operate versus continuing with IV antibiotics. Specifically, it does not capture the number of Kanavel signs, the presence of an abscess on imaging, or the Michon stage - the variables that most directly inform the decision to operate - and these could not be incorporated into the propensity-score model. Therefore, this information limits the explanatory nature of certain outcomes measured in this study. Despite the limitations of this study, an attempt to control for potential confounders was made. This included propensity score matching of patients by age, gender, race, and ethnicity to ensure the comparison between cohorts was as fair and unbiased as possible, given the observational nature of the data.

    Trends in the Management of Acute Pyogenic Flexor Tenosynovitis of the Hand: A Comprehensive Analysis · 2026 · DOI

  • There is a lack of prospective outcome data on EIP-to-EPL tendon transfer in patients with EPL rupture secondary to DRF. The study aims to address this gap by evaluating functional and patient-reported outcomes after EIP-to-EPL tendon transfer.

    Functional results after extensor indicis proprius to extensor pollicis longus tendon transfer for ruptures associated with distal radius fractures · 2026 · DOI

Most-cited papers in Orthopedic Surgery and Rehabilitation

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148 open questions have been extracted from the limitations and future-work passages of 541 Orthopedic Surgery and Rehabilitation papers in our library. Each one below links back to the study that raised it, so you can read the original claim in context.

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