The purpose of this systematic review and meta-analysis was to evaluate human biomechanical studies investigating ulnar collateral ligament (UCL) reconstructions using an internal brace mechanical augment construct. A search following PRISMA guidelines was performed in August 2025 across PubMed, Cochrane, and Web of Science databases to identify studies reporting biomechanical outcomes of UCL reconstructions in isolation compared to UCL reconstruction with an internal brace. A total of 329 studies were reviewed, with 6 meeting inclusion criteria. Data on ultimate failure torque (Nm), stiffness (Nm/deg), ulnohumeral gapping (mm), and valgus laxity (deg) were extracted. A meta-analysis comparing these four biomechanical parameters was conducted using a systematic review, a random-effects model, and pooled standardized mean differences (SMD). For ultimate failure torque, the pooled SMD was 1.54 ([-0.28 to 3.35], p = 0.074), trending towards higher torque strength for internal brace. For graft stiffness, the pooled SMD was 0.91 ([-0.17 to 1.99], p = 0.068), trending towards higher stiffness for the internal brace constructs. For ulnohumeral gapping, the pooled SMD was -0.52 ([-1.01 to -0.03], p = 0.043), indicating a statistically significant effect of less gapping for the internal brace. Internal brace augmentation resulted in decreased ulnohumeral gapping and demonstrated favorable biomechanical trends compared with traditional UCL reconstruction, suggesting improved early construct stability.

High-energy bicondylar tibial plateau fractures of Schatzker types V and VI are conventionally managed, after open reduction and internal fixation, with 6-12 weeks of restricted weight-bearing, out of concern for loss of reduction and articular collapse. Emerging evidence questions whether this restriction is necessary. Reports of immediate weight-bearing specifically after fixation of these most unstable bicondylar patterns remain scarce, as most comparative studies pool this subtype within mixed cohorts. We present three consecutive patients (two men and one woman; mean age: 54 years; all of North Indian ethnicity) with closed, high-velocity Schatzker type V-VI tibial plateau fractures sustained in road traffic accidents. Each was treated with open reduction and internal fixation using a dual-plate or three-plate construct, with allograft impaction of the metaphyseal void created after the elevation of the depressed articular fragments. In departure from the conventional restricted protocol, each patient was mobilised to full weight-bearing as tolerated from the first postoperative day, using a walking aid for balance rather than for offloading, with early active range-of-motion exercises and no brace. At six weeks, all three patients had achieved independent ambulation with a walking aid, knee flexion beyond 90 degrees, no pain during activities of daily living, and a clinically acceptable gait. Follow-up radiographs showed no loss of fixation, screw cut-out, or articular collapse, and no patient sustained a wound complication, infection, or revision surgery. Immediate unrestricted full weight-bearing after stable plate fixation of Schatzker type V-VI tibial plateau fractures appears safe and may accelerate functional recovery. These observations are concordant with recent randomised and comparative literature and are underpinned by a coherent bone-biological rationale in which physiological loading promotes rather than jeopardises union. This report supports a considered shift away from routine prolonged non-weight-bearing towards individualised, stability-guided early mobilisation, even for the most unstable bicondylar patterns, provided the fixation construct is intraoperatively judged sound. Larger prospective comparative studies are needed to confirm these findings and refine patient selection.

Prolonged physical inactivity induces rapid neuromuscular deconditioning, with aging influencing both the rate, recovery and nature of these changes. However, its effects on the modulation of motoneuron excitability across age groups remain unclear. This study examined how bed rest and subsequent endurance retraining influence persistent inward current (PIC)-related estimates, motor-unit (MU) discharge behavior, and circulating tryptophan (TRP) and kynurenine (KYN) biomarkers in healthy young and older males.

Legg-Calvé-Perthes disease (LCPD) is a self-limiting avascular necrosis of the femoral head in children, with management aimed at preserving hip joint congruency and reducing the risk of long-term degenerative changes. Bracing is a commonly used containment strategy; however, its effectiveness remains controversial owing to variation in brace design, biomechanical principles, and treatment protocols. This systematic review evaluates and synthesizes the variability in bracing design and bracing protocols for non-operative management of LCPD. This review adhered to the PRISMA-ScR guidelines. A comprehensive search of PubMed, Scopus, Science Citation Index, and Google Scholar was performed using keywords such as "Perthes" OR "Coxa Plana" and "treatment" OR "non-operative" OR "orthoses" OR "conservative" OR "brace". Only full-text articles in English were included. Studies were required to document initial radiographs using the Catterall or Herring classification and assess outcomes with the Mose or Stulberg criteria. Exclusion criteria included non-English language articles and research with inadequate methodology. Patient demographics, therapy type, type of bracing, and radiological results were among the information retrieved. Radiographic results were classified as good or poor using the Mose and Stulberg ratings. A total of 12 studies were examined to determine the efficacy of conservative treatments, especially bracing, for LCPD. Age of onset was a key prognostic factor, with better outcomes indicated in children under the age of eight. Bracing was more beneficial in younger individuals with milder illness, although adherence was crucial. Various braces, including the Atlanta Scottish Rite, trilateral socket, and non-weight-bearing ambulatory hip abduction brace, have been developed to maintain hip abduction. However, limitations such as discomfort, poor adherence, reduced mobility, and inconsistent radiological and clinical outcomes undermine their efficacy. Additionally, significant variability exists in indications, duration, and patient selection, with no universally accepted bracing protocol. Despite theoretical containment advantages, the effectiveness of bracing in LCPD remains inconclusive due to heterogeneity in brace designs, patient selection, and treatment protocols, as well as limitations in the underlying evidence base. Further prospective, methodologically robust studies with standardized protocols and transparent reporting of adherence are needed to clarify the role of bracing in clinically meaningful outcomes.

The study of biography is important to understand the principles of our profession and the intersections of the lives of the key figures in our spine deformity history. We hope that by telling these stories this history will come alive. The surgeons who came before us, as exemplified by Dr. John Emmett Hall, understood the importance of unwavering principles, developing close professional relationships, the value of travel, and the power of collaboration. The legacy of his full life is summed up by the plaque placed by the nurses in his operating room, at Boston Children's Hospital: "The Dr. John E. Hall Room: Dedicated to Compassion, Respect, and Excellence".