AO Trauma Research Grants

AO Trauma Research Grants is sponsored by AO Foundation. AO Trauma offers research grants that fund clinical, basic, and applied research focused on solving highly relevant problems in trauma and musculoskeletal care, including fracture non-union and fragility fractures. These opportunities are available to AO Trauma clinicians from all global regions.

Global and regional funding and training opportunities for Trauma research excellence As part of its commitment to supporting individual research career development for clinicians, AO Trauma offers research grants that fund clinical, basic, and applied research focused on solving highly relevant problems in trauma and musculoskeletal care.

These opportunities are available to AO Trauma clinicians from all global regions—Europe and Southern Africa (ESA), Middle East and Northern Africa (MENA), Asia Pacific (APAC), North America (NA), and Latin America (LATAM).

In addition to traditional research grants, AO Trauma is advancing structured training opportunities for young investigators, including the development of training grants, enhanced research mentorship, and innovative surgical training courses that promote best practices in preclinical and clinical research. These initiatives aim to foster a culture of excellence, innovation, and evidence-based care across the trauma community.

Have a bold idea in trauma research? Apply for funding through AO Trauma’s open grant calls and contribute to advancing evidence-based care in musculoskeletal trauma.

AO Trauma Mini Grant Funded Research Projects Funding year: 2026 - Projects funded in Europe and Southern Africa AOTrauma_S_ESA_2026-02933: CARBO Principal Investigator: Viktor Mili-Schmidt, Danderyd Hospital, Sweden Metacarpal fractures are among the most common hand injuries. A poorly healed hand fracture causes grip weakness, pain, stiffness, and difficulty performing precise hand movements, affecting daily tasks and activities.

Limited high-quality evidence guides their optimal treatment. Surgery has historically been the gold standard for displaced fractures but a small recent investigation suggests less remaining disability after direct mobilization without surgery or casting. If we can strengthen such evidence, it would change treatment practice, shorten return to activity and reduce complications for these patients, with the added benefit of less costs.

Research questions: Does non-surgical management of displaced metacarpal fractures result in grip strength at 12 months post-injury that is non-inferior to that achieved with surgical fixation? How does treatment modality affect time to return to activity?

Methodology: The CARBO project consists of three interlinked studies: (1) a multi-center, non-inferiority randomized controlled trial (RCT) comparing surgical and non-surgical treatment for displaced metacarpal fractures, (2) a comparison of the carbon footprint of treatment options (prospective cohort alongside the RCT) and (3) and a separate qualitative study exploring active patients experiences of treatment selection.

The primary outcomes include grip strength at 12 months (CARBO 1), carbon dioxide equivalent (CO2e) emissions per treatment method (CARBO 2) and 3) a separate analysis of patients ™ experience of different treatment options.

Impact: This project aims to address critical knowledge gaps in how to treat patients with metacarpal fractures by integrating clinical, and patient- reported perspectives, ensuring robust and impactful findings to change future metacarpal fracture management. AOTrauma_S_ESA_2026-02983: SCOT-POPFF: Predictors of failure and management algorithms for PTS POPFF Principal Investigator: Matthew Kennedy, University of St.

Andrews, UK Postoperative periprosthetic femoral fractures (POPFFs) are increasing and are associated with high mortality and reoperation rates. UCS-B fractures represent the most complex and heterogeneous subgroup, yet current subclassification (B1 “B3) relies on subjective assessment of stem stability and bone stock, with limited reproducibility and poor discrimination of failure risk.

Fracture morphology, a cornerstone of trauma surgery, is not formally incorporated into UCS-B decision-making. A multicentre UCS-B collaboration (2015 “2025) and the forthcoming inclusion of PFFs within the Scottish Hip Fracture Audit (SHFA) with national linkage from 2026 onward together provide a unique opportunity to generate robust, scalable evidence.

Population: Adults with UCS-B periprosthetic femoral fractures treated in participating UK centres (2015 “2025), with national SHFA-linked cohorts from 2026 onward. Intervention: Surgical management using fixation, revision arthroplasty or combined strategies. Comparator: UCS-B1 vs B2 vs B3 and morphology-defined subgroups within UCS-B.

Outcomes: Primary outcome is treatment failure defined as reoperation or revision of the index hip; secondary outcomes include mortality and implant survival. Time: Minimum 12-month follow-up for the multi-centre study and 12 month follow up for the SHFA PFF dataset following inclusion. Multicentre imaging review will classify fracture morphology (pattern, comminution, calcar and cortical involvement, stem “fracture relationship).

These features will be integrated with clinical and implant variables in multivariable models to identify independent predictors of failure. A morphology-augmented UCS-B subclassification will be developed in the multicentre cohort and validated in the national SHFA-linked population.

AOTrauma_S_ESA_2026-03038: Biomechanical analysis of fixation strategies in geriatric acetabular fractures Principal Investigator: Fenna Brunken, BG Klinik Ludwigshafen, Germany The incidence of acetabular fractures in geriatric patients is increasing, with anterior column posterior hemitransverse fractures (ACPHT) representing the most common fracture pattern.

Established treatment strategies often require extensive surgical approaches and prolonged restrictions in weight-bearing. Percutaneous screw fixation combined with a multi-hole acetabular cup may represent a less invasive alternative.

However, biomechanical data on the stability of this construct under full weight-bearing conditions and direct comparisons with plate fixation combined with multi-hole cups or antiprotrusio cages in ACPHT fractures are lacking. The aim of this study is to compare the biomechanical stability of three fixation strategies for ACPHT fractures in geriatric patients.

Standardized ACPHT fractures with posterior wall involvement and dome impaction will be created in osteoporotic hemipelvis Sawbone models using 3D-printed templates.

Twenty-four specimens will be allocated to three study groups (n = 8 per group): (1) dorsal and ventral plate osteosynthesis combined with an antiprotrusio cage, (2) dorsal and ventral plate osteosynthesis combined with a multi-hole cup, and (3) cannulated screw osteosynthesis combined with a multi-hole cup. After fixation, specimens will undergo cyclic axial loading under standardized conditions.

Biomechanical stability will be assessed by the number of cycles and maximum load until construct failure, defined as a loss of load-bearing capacity ≥30% or fragment displacement ≥2 mm. Interfragmentary motion and prosthesis subsidence will be recorded using optical motion tracking.

This study aims to generate new biomechanical data on screw fixation combined with a multi-hole acetabular cup in ACPHT fractures to assess whether biomechanical stability comparable to established plate-based fixation strategies can be achieved, thereby contributing to the evaluation of less invasive treatment strategies for geriatric acetabular fractures.

AOTrauma_S_ESA_2026-03053: Preoperative Planning in ESIN: A Software-Guided Approach Principal Investigator: Andrea Audisio, A. O. U.

Citta della Salute e della Scienza di Torino, Italy Elastic Stable Intramedullary Nailing (ESIN) is a validated treatment for pediatric long-bone fractures. Despite its widespread use, ESIN remains highly experience-dependent. Critical technical decisions including nail bending, point of insertion, canal fill ratio, and the use of end caps are frequently made empirically.

This variability contributes to inconsistent construct stability, secondary loss of reduction, angular deformity, and the need for reintervention, particularly in unstable fracture patterns and in heavier or older children. The aim of this project is to develop and validate a software for preoperative ESIN planning. We hypothesize that software-assisted planning will reduce malunion rates.

We have completed a retrospective observational study of pediatric femoral shaft fractures treated with ESIN, establishing a curated clinical and radiographic database including fracture characteristics, implant configuration, alignment, and outcomes. We also performed an initial computational analysis quantifying variations how nail curvature and canal fill influence construct stability.

Building on these preliminary results, we will extend clinical analysis to include tibia, and humerus fractures; perform parametric analysis to quantify the mechanical contribution of nail geometry and end cap usage to different fracture patterns and anatomic region; and (3) integrate identified stability determinants into our software.

Expected results include identification of biomechanical stability thresholds, objective criteria for ESIN configuration, and demonstration of association between predicted stability and clinical outcomes.

The long-term goal of the project is to standardize ESIN preoperative planning across pediatric long bones, reduce operator dependence, improve reproducibility of fixation, and provide a foundation for future prospective multicenter validation studies.

AOTrauma_S_ESA_2026-03055: Evaluation of cement-augmented screw configurations in the treatment of PHF Principal Investigator: Antonia Schlüssler, Universitätsklinikum Carl Gustav Carus Dresden, Germany Plate osteosynthesis is one of the standard procedures for treating proximal humerus fractures.

Cement augmentation of the screws is commonly performed, especially in geriatric populations, to prevent osteosynthesis failure or secondary dislocation with varus collapse. Despite the widespread use of this procedure, there is a lack of validated data on the ideal screw configuration (positioning and number) for this type of treatment.

In a biomechanical study using human humerus specimens we therefore aim to evaluate different screw configurations in terms of maximum achievable stability (cyclic load and load-to-failure) and compare them with a control group without cement augmentation.

In addition to identifying the most stable screw configuration, the aim of the study is to derive a recommendation for action that can be practically translated into everyday clinical practice.

AOTrauma_S_ESA_2026-03165: Targeting mechanosensitive channels to improve implant integration Principal Investigator: Christoph Beyersdorf, University Hospital Düsseldorf, Germany Osteoporosis compromises bone quality and significantly increases the risk of implant loosening and failure after fracture fixation.

While advances in implant design have improved primary mechanical stability, strategies to enhance biologically driven osseointegration in osteoporotic bone remain limited. Emerging evidence suggests that mechanosensitive ion channels regulate both osteoblast differentiation and macrophage polarization, positioning them as promising targets to modulate the peri-implant microenvironment.

Aims: This project aims to develop biofunctional titanium implant surfaces that locally activate mechanosensitive ion channels and to evaluate their effects on osteoblast osteogenesis and osteomac polarization under osteoporotic conditions, pursuing a translational approach to improve implant performance in osteoporotic bone.

Materials and Methods: Titanium discs will be coated with selective ion channel activators using a polymer-based carrier system. Primary human osteoblasts and osteomacs isolated from elderly donors will be cultured on coated and uncoated titanium. Osteogenic differentiation will be assessed by mineralization assays, ALP activity, and gene expression analysis.

Macrophage polarization will be evaluated by qPCR and ELISA of inflammatory and regenerative cytokines. Conditioned media experiments will assess osteoimmune crosstalk. Expected Results: We expect that implant-mediated ion channel activation promotes a regenerative (M2-dominant) immune phenotype and enhances osteoblast-driven mineralization, thereby improving the biological conditions for osseointegration in osteoporotic bone.

Long-term Goal: The long-term objective is to establish a novel biofunctional implant strategy that restores bone “immune homeostasis at the implant interface, reduces implant failure in osteoporotic fracture care, and enables further translation into in vivo and ultimately clinical applications.

AOTrauma_S_ESA_2026-03186: Photodynamic Bone Stabilization System for treatment of pelvic ring fractures Principal Investigator: Charlotte Arand, Universitätsmedizin Mainz, Germany During the last decade we observed an increasing incidence of insufficiency fractures of the pelvis.

In those typically frail patients the main demands on the therapy are to be as less invasive as possible on the one hand, and to allow for immediate mobilization of the patient on the other hand. Those criteria have to be met for both conservative and operative treatment modalities. If an operative treatment is required, minimally invasive stabilization techniques are preferred.

  Usage of conventional implants, that are commonly used for stabilization of the dorsal pelvic ring like (trans-) iliosacral screws or bars, might be limited due to narrow or curved osseous corridors. In such cases conversion to a more invasive procedure is often required. Photodynamic Bone Stabilization Systems (PBSS) represent an innovative and minimally invasive fixation option.

These systems offer the opportunity to introduce a flexible balloon catheter into a non-linear intramedullary corridor. After positioning the catheter is filled with a liquid polymer that polymerizes upon exposure to ligh t of a specific wavelength and achieve thereby an intramedullary augmentation and stabilization.

The procedure is minimally invasive and maintains to achieve stable fixation by an intramedullary trans-iliosacral implant even in complex anatomical conditions.

The aim of the presented project is to evaluate the primary stability of such a photodynamic stabilization system for treatment of FFP IIIc fractures on artificial, osteoporotic bone models as a trans-iliosacral standalone implant, or in combination with an additional iliosacral screw within an established and standardized biomechanical test setup, and to compare the outcome with a conventional trans-iliosacral implant.

AOTrauma_S_ESA_2026-03200: Pelvic incidence: a potential risk factor for fracture progression of FFP? Principal Investigator: Moritz Friedrich Lodde, UKM Unfallchirurgie, Germany Insufficiency fractures of the pelvic ring affect elderly patients with reduced bone quality, causing substantial morbidity and mortality rates up to 27%. Fracture progression occurs in 11-16% of cases, particularly in conservatively treated patients.

Spinopelvic parameters, specifically pelvic incidence, are altered in patients with pelvic insufficiency fractures and may influence fracture behavior and treatment outcomes. Hypothesis: This study hypothesizes that increased pelvic incidence represents a biomechanical risk factor for fracture progression in pelvic insufficiency fractures and influences the effectiveness of posterior pelvic ring stabilization techniques.

Methods: A three-phase biomechanical investigation will be conducted: (1) finite element (FE) analysis comparing low (51°) versus high (64°) pelvic incidence groups regarding stress distribution and fracture progression; (2) validation using human cadaver specimens; and (3) biomechanical testing using artificial bone models.

Three common osteosynthesis techniques (unilateral sacroiliac screw, bilateral sacroiliac screws, and transsacral screw fixation) will be evaluated under different pelvic incidence conditions.

Expected Impact: Results will provide evidence-based guidance for improved diagnosis and treatment of pelvic insufficiency fractures, potentially establishing pelvic incidence as a clinically relevant parameter in therapeutic decision-making algorithms.

AOTrauma_S_ESA_2026-03210: Biophysical and Bioelectrical Mechanisms of Blast-Induced Sinonasal Injury Principal Investigator: Olena Kvasha, State institution œInstitute of Otolaryngology of the National Academy of Medical Science of Ukraine, Ukraine Blast-related injuries are increasingly recognized as a major cause of chronic sinonasal pathology among military personnel and civilians exposed to repeated explosive events.

In many of these patients, chronic rhinosinusitis represents a form of barosinusitis driven by blast-induced pressure waves rather than classical inflammatory mechanisms. Conventional functional endoscopic sinus surgery, based on wide sinus ventilation and drainage, may be inadequate or even harmful in this population.

Paranasal sinuses represent an evolutionarily and biomechanically optimized system of pressure dampers and energy-dissipation chambers that protect the skull base during rapid pressure fluctuations. Surgical disruption of these structures may increase the risk of skull base fractures, cerebrospinal fluid leakage, meningitis, and severe traumatic brain injury following repeated blast exposure.

This project aims to investigate the biophysical and bioelectrical mechanisms of sinonasal tissue injury following blast and barotraumatic exposure and to redefine trauma-adapted diagnostic, surgical, and conservative management strategies for affected patients. A comparative clinical study will be conducted in patients with CRS and barosinusitis with and without a history of blast exposure.

Clinical presentation, endoscopic findings, imaging data, and histopathological and immunohistochemical markers of vascular injury, oxidative stress, inflammation, and tissue remodeling will be analyzed. Exploratory evaluation of bioelectrical alterations related to membrane integrity, ionic balance, and tissue conductivity will be performed to identify mechanisms linking blast exposure to chronic barosinusitis.

The expected outcome is the identification of biomechanical and biological predictors of complicated disease course and the development of personalized, trauma-adapted treatment algorithms aimed at reducing postoperative complications and improving long-term outcomes in blast-exposed patients.

Funding year: 2026 - Projects funded in Latin America AOTrauma_S_LATAM_2026_1-03173: Early vs Traditional Weight-Bearing in Schatzker II Fractures:A Randomized Trial Principal Investigator: José Laso, Hospital del Trabajador ACHS Salud, Chile Schatzker type II tibial plateau fractures cause significant morbidity and prolonged sick leave in working-age adults.

Despite surgical advances, postoperative rehabilitation remains conservative; delayed weight-bearing is often based on theoretical concerns rather than robust evidence. Current studies lack specificity for Schatzker II fractures, the subtype most prone to articular subsidence.

Objective: To evaluate the efficacy and safety of early weight-bearing (EWB) versus traditional non-weight-bearing (NWB) protocols in patients with work-related Schatzker II fractures over a 6-month period. Methods: This randomized controlled trial (1:1 parallel-group) at a Level I trauma center in Santiago, Chile, will enroll 34 participants. The EWB group starts toe-touch at week 3 and full weight-bearing (FWB) at week 4.

The NWB group starts toe-touch at week 7 and FWB at week 11. The primary outcome is time to return-to-work, analyzed via Kaplan-Meier curves and Cox proportional hazard models. Secondary outcomes include radiographic maintenance of reduction, functional recovery (IKDC, Lysholm, KOOS), and complications.

The protocol is prospectively registered and ethics committee approved. Expected Results: We hypothesize that EWB will significantly shorten sick leave and improve functional recovery and quality of life, maintaining a safety profile and articular reduction comparable to NWB. These findings aim to bridge the evidence gap and optimize evidence-based recovery protocols for high-demand patients.

Funding year: 2025 - Projects funded in Asia Pacific AOTrauma_S_APAC_2025-01673: Development of innovative implant for Hoffa fracture Principal Investigator: Harjot Gurduatta, Shri Akal Purakh Hospital, India Abstract Hoffa fractures, once considered simple posterior condylar injuries, have shown complex comminution patterns and multiple fracture lines, necessitating improved fixation methods.

This proposal outlines the development of a novel, anatomically contoured implant system specifically designed for Hoffa fractures. The system includes a curvilinear base plate and a multi-pronged buttress component to stabilize articular and metaphyseal fragments. Biomechanical testing will be conducted on dry bones, cadavers, and patient models, building on an initial successful pilot in five lateral Hoffa cases.

The implant aims to enhance fracture stability, enable early mobilization, and offer superior tissue coverage due to its low-profile, moldable design. The one-year project includes design, prototyping, clinical testing, and biomechanical validation, with an estimated budget of USD 15,000.

AOTrauma_S_APAC_2025-01707: Assessing pelvic stability during physiological loading in cadaveric models Principal Investigator: Qinxiang Shant Sin, Ministry of Health Holdings, Singapore Pelvic ring injuries are caused by severe trauma such as road traffic accidents and crush injuries. These patients may be in a foreign country and may wish to be treated back in their home country.

Repatriation back is a challenge as pelvic ring injuries are severe and patients may not be able to tolerate sitting upright or lying in a reclining seat in a long flight. Lying flat may require additional logistics and costs which may be unfeasible for the patient. Based on current literature, there is a lack of established protocols that support the safety of such patients to sit or stand.

This leaves an uncertainty in patient's positioning if repatriation was required. The decision is left to the discretion of the treating physician, of which some may disallow repatriation due to perceived pelvic instability. This study involves 6 cadaveric pelvis models that tests the tension and durability of remaining ligaments when one or more ligaments have been damaged.

Tension meters will be placed on all major pelvic ligaments (pubic symphysis, sacrotuberous, sacrospinous, anterior sacroiliac joint, posterior sacroiliac joint ligaments). The pelvic specimen will be clamped and fixed in sitting and standing positions. A physiological load will be applied to the models and the baseline tension force in these tension meters will be measured.

Subsequently, each ligament will be surgically sectioned sequentially from anterior to posterior to mimic ligament rupture. The maximum physiological load to keep the pelvis stable during each position will be recorded. This aims to assess the pelvic stability in a physiological standing or sitting position.

This study can be extrapolated into a clinical setting to guide physicians in deciding the positioning of patients for repatriation or medical transfers. The results obtained can also be used to craft rehabilitation protocols for patients with conservatively treated pelvic ring injuries to start mobilization (sitting or standing) earlier.

AOTrauma_S_APAC_2025-01845: Anthropometric Measurement for Estimated Femoral Nail Length Principal Investigator: Mohd Afiq Bin Muhamed Fuad, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Malaysia Choosing the correct intramedullary nail length is critical for the successful fixation of femoral-shaft fractures. Current standards rely on X-ray measurements or the uninjured femur?

methods that are impossible in bilateral fractures, expose patients to radiation, and are difficult in obesity or pregnancy. We propose a simple anthropometric alternative: using palpable fibula length to estimate maximum femoral nail length (EFNL). Aims: Quantify the correlation between clinical fibula length and EFNL.

Derive a predictive formula for EFNL based solely on fibula length. Verify measurement reliability between observers. Explore whether age, sex, height or weight influences the correlation.

A reliable, tape-measure method eliminates unnecessary imaging, shortens operating-room preparation, lowers costs, and offers a safe option for polytrauma and radiation-sensitive patients. Materials & Methods Design: single-centre, cross-sectional study. Setting: Orthopaedic clinic and ward, Hospital Sultan Abdul Aziz Shah (HSAAS).

Population (P): 130 ambulatory patients, 12–60 y, without lower-limb deformity. Intervention (I): Clinical measurement of fibula length (head styloid – lateral malleolus) by two blinded observers. Comparison (C): Clinically estimated EFNL (greater trochanter – line perpendicular to superior patella).

Outcome (O): Strength of correlation, predictive equation, inter- and intra-observer reliability. Time frame (T): Single measurement session per patient (Jun 2025–July 2026). Analysis: Spearman correlation, zero-intercept linear regression, multiple regression for covariates, and intraclass correlation coefficient (ICC) for reliability.

Expected Results: Fibula Length have significant correlation with EFNL. Long-term Goal: To integrate fibula-based EFNL estimation into routine orthopaedic practice especially those with bilateral femoral injuries or conditions that preclude conventional measurement.

AOTrauma_S_APAC_2025-01852: Clinical efficacy of 3D Ti- and Mg-implants for repairing peri-articular defects Principal Investigator: Bingchuan Liu, Peking University Third Hospital, China The treatment of bone defects in the peripheral joints of the limbs is a challenging problem in orthopaedic clinical practice, and traditional methods are unable to achieve efficient and safe repair of complex bone defects.

The use of emerging 3D printing technology for the treatment of bone defects offers the advantages of personalisation and precision. Our research team has successfully treated over 100 patients with limb bone defects using 3D-printed titanium alloy bone implants, accumulating extensive experience in the process.

Additionally, we have completed in vitro and in vivo performance tests for 3D-printed magnesium alloy bone implants and obtained the necessary ethical approval for clinical trials, marking a pioneering exploration not yet reported in domestic or international literature.

Based on this foundation, this project will fully leverage the advantages of prior research and practical experience to conduct an in-depth comparison of the clinical efficacy differences between using 3D-printed titanium alloy and magnesium alloy bone implants for repairing limb joint bone defects.

The focus will be on customised design and production of bone implants, stable fixation patterns, characteristics of new bone regeneration, degradation patterns of magnesium alloy implants, joint function rehabilitation, and complications.

The research findings will help comprehensively and deeply address the challenges encountered in the clinical application of 3D printing technology in orthopaedics, provide new materials and technologies for the clinical treatment of bone defects around the joints of the limbs, and lay the foundation for the clinical translation of products and the initiation of multi-center studies.

AOTrauma_S_APAC_2025-01865: AI-Driven 3D Reconstruction of Pediatric Supracondylar and Lateral Condyle Humerus Principal Investigator: Shigeki Ishibashi, Hiroshima University Hospital, Japan Background: Assessing complex pediatric elbow fractures, particularly those involving the epiphyseal plate, is challenging with 2D radiographs alone.

While computed tomography (CT) provides essential 3D detail, it poses risks of radiation exposure and higher costs in pediatric care. Deep learning can reconstruct 3D models from X-rays, but a clinically validated model for the unique anatomy of the pediatric elbow is a critical unmet need.

Objective: This study aims to develop and validate a deep learning algorithm that accurately reconstructs 3D models of pediatric supracondylar and lateral condyle humerus fractures from biplanar radiographs, with the goal of creating a reliable alternative to pre-operative CT scans.

Methods: Using a retrospective, multicenter dataset of 250 patients with paired radiographs and CT scans, we will train a deep learning model featuring a dual-stream 2D encoder and a 3D U-Net decoder to generate 3D bone geometry. Model accuracy will be rigorously validated against CT-derived ground-truth models using metrics such as the Dice Similarity Coefficient (DSC) and mean surface distance.

Anticipated Results: We hypothesize that the algorithm will reconstruct the fracture geometry with a mean surface error of less than 2. 0 mm and achieve a DSC greater than 0. 85.

The resulting 3D models are expected to provide clinically reliable anatomical information for accurate diagnosis and surgical planning. Conclusion & Significance: A successful model would offer a novel diagnostic tool to improve surgical planning for complex pediatric elbow fractures while significantly reducing the need for CT scans and their associated radiation and costs.

Furthermore, this technology could enable 3D assessment of fracture healing from routine follow-up radiographs, establishing a new paradigm in pediatric orthopedic imaging.

AOTrauma_S_APAC_2025-01885: AI-CT Quantification of Muscle Recovery in High-Energy Fracture Patients Principal Investigator: Suguru Yokoo, Fukuyama City Hospital, Japan Background: High-energy pelvic and femoral fractures precipitate rapid lower-limb muscle atrophy and fatty infiltration, delaying rehabilitation and prolonging disability.

Current CT-based workflows rely on manual slice measurements that are subjective, slow, and poorly reproducible, and no automated volumetric tool exists to guide early, muscle-specific therapy.

Aim: This study will (1) apply a Bayesian 3D U-Net pipeline to quantify immediate postoperative (< 7 days) volume loss in key lower-limb muscles of 150 adult fracture patients, and (2) predict and internally validate their recovery trajectories at 3 and 6 months. Relevance: Early identification of muscle groups at risk for delayed regeneration enables personalized rehabilitation, improves functional gains, and reduces inpatient stays.

Methods: In this retrospective cohort (2018–2025), we will automatically segment quadriceps, hamstrings, abductors/adductors, and flexors on serial CTs (preoperative, postoperative &le; 7 days, 3 month, 6 month). We will quantify absolute and relative volume changes, stratify by fracture type, age, and sex, and correlate muscle‐volume changes with change in Barthel Index at 3 months, length of stay (LOS), and return‐to‐home rate.

Expected Results: We anticipate identifying at least two muscle groups with early volume loss &ge; 15 %, and that such early losses will independently predict a &ge; 10-point lower Barthel Index at 3 months and a 20 % longer LOS compared with patients without significant early loss.

Long-term Goal: To integrate CT-derived recovery maps into standard post-fracture care protocols, thereby enabling data-driven, individualized physiotherapy regimens. P—Adults with high-energy pelvic/femoral fractures; I—AI-CT segmentation plus targeted early rehab; O—Muscle‐volume change vs. Barthel Index change at 3 months (primary); secondary: LOS and return‐to‐home rate; T—Baseline through 6 months.

AOTrauma_S_APAC_2025-01889: Cutting Risk Before the Cut: Fructosamine’s Role in Infection Prediction Principal Investigator: Ashok Ramanujam, Mahatma Gandhi Medical College & Research Institute, India Introduction and Background: Postoperative infections remain a significant complication in orthopaedic trauma surgery, particularly among patients with impaired glucose metabolism.

Glycemic control is a known determinant of surgical outcomes, yet traditional markers such as HbA1c reflect long-term glucose control and may not capture rapid changes prior to surgery. Serum fructosamine, a marker of short-term glycemic status (2–3 weeks), has shown emerging potential as a predictive biomarker for postoperative infections but is underutilized and under-researched in the orthopaedic trauma setting.

This study aims to fill this critical knowledge gap. Aim: The primary aim is to evaluate the association between preoperative serum fructosamine levels and the incidence of postoperative infections in orthopaedic trauma patients. Measuring serum fructosamine levels preoperatively in patients undergoing trauma surgery.

Monitoring and recording postoperative infections over a defined follow-up period. Design: Prospective, observational cohort study. Study Period: September 1, 2025–September 30, 2027.

Population (P): Adult patients ( &ge; 18 years) undergoing orthopaedic trauma surgery. Intervention (I): Measurement of serum fructosamine levels within 48 hours prior to surgery. Comparison (C): Outcomes compared across patients with normal vs. elevated fructosamine; secondary comparison with HbA1c levels.

Outcome (O): Incidence of surgical site infections (superficial and deep), including periprosthetic joint infections where applicable. Time (T): Follow-up period of 90 days postoperatively for infection Expected Results: We anticipate that elevated serum fructosamine levels will be significantly associated with higher rates of postoperative infections.

AOTrauma_S_APAC_2025-01897: Evaluating Humeral Stem Length on Implant Mechanics in Total Elbow Arthroplasty Principal Investigator: Merrill Lee, Singapore General Hospital, Singapore Expanding indications subjects the Total elbow arthroplasty (TEA) to increased mechanical stresses leading to potential complications such as loosening, implant component fracture and peri-prosthetic fracture.

This computational analysis aims to investigate the overall biomechanical performance of the total elbow implant in response to varying implant lengths. By utilising different implant lengths, we hope to demonstrate its effect on the bone and implant stresses and identify changes in the load transfer pattern. We hypothesize that modifying the implant length will result in changes in the bone and implant stresses.

We also hypothesize that by using the optimum implant length, we can restore the bone stresses in the bone-prosthesis assembly to its intact state. Three synthetic humerus and ulna sawbones as well as its corresponding digital models to perform computational analyses will be used.

Distal total elbow implants of varying lengths will undergo laser scanning to obtain the three-dimensional (3D) digital models which will then be used to generate bone-prosthesis assemblies. The models will be exported to a finite element solver software for simulation.

Three load cases at specified flexion angles with the corresponding axial loads calculated with respect to joint reaction force and flexion angle as well as a torsional moment will be applied for both experimental and computational analysis. Strain readings from experimental testing and computational analyses will be compared at respective locations to validate the intact model.

The stresses and strains across the bone-implant assemblies with varying implant lengths are evaluated after separating the cortical bone, cancellous bone and implant. The following study will possibly guide clinicians in determining the optimum implant length with improved biomechanical performance for their patients and potentially reduce the incidence of mechanical complications.

AOTrauma_S_APAC_2025-01908: Ultrasonic automated screw tunnel depth gauge for orthopaedic surgery Principal Investigator: Kia Teng Lim, National University Hospital, Singapore Our research aims to develop a novel depth gauge that integrates guiding sleeves, an embedded ultrasound probe, and an electronic screw length measurement system to enhance accuracy in orthopaedic screw placement, particularly in trauma surgery.

Traumatic injuries remain a major global health burden, with fracture fixation being one of the most common surgical interventions. Screws are widely used not only in trauma care but also in procedures like total hip replacements and limb deformity corrections. Current screw placement relies on manual depth gauges and memory of the drilled trajectory after removal.

Inaccuracy in screw placement and screw length measurements using depth gauges remains an obstacle—studies reveal that ideal screw placement is achieved in only 49. 2% of cases, with no difference between senior and junior surgeons. Incorrect screw lengths compromise fixation integrity—short screws may fail to engage the far cortex, while long screws risk damaging soft tissues or neurovascular structures.

Repeated screw removals due to miscalculations can prolong surgeries, increase costs, and damage bone integrity. Repeated intra-operative imaging to confirm placement accuracy exposes both patients and surgical teams to ionizing radiation, which poses health risks and extends operative time. Our multidisciplinary team comprising orthopaedic