Journal of Orthopaedic Reports最新文献

{"title":"Periprosthetic fracture around intramedullary magnetic femoral nail: Management and case report","authors":"Egor Kostin ,&nbsp;Paraskevas Miltiadou ,&nbsp;Charalambos Charalambides ,&nbsp;Ioannis Orfanos","doi":"10.1016/j.jorep.2024.100439","DOIUrl":"10.1016/j.jorep.2024.100439","url":null,"abstract":"<div><h3>Background</h3><p>The intramedullary magnetic nail is an advanced technique in limb lengthening surgery, offering precise bone healing with minimal soft tissue disruption. However, increased use has led to a rise in periprosthetic fractures, and no standardized treatment protocols exist. This case report presents an innovative approach to managing such fractures without interrupting the limb lengthening process.</p></div><div><h3>Case report</h3><p>A 21-year-old male with a 120mm limb length discrepancy, due to childhood osteomyelitis, underwent limb lengthening surgery with an intramedullary magnetic femoral nail. Twelve days postoperatively, he sustained a periprosthetic fracture around the proximal screws of the nail following a fall. We opted to continue the lengthening therapy by securing the fracture with a proximal femoral plate using one of the nail's screws. This approach allowed uninterrupted lengthening therapy. Follow-up confirmed stable fixation and successful limb lengthening, achieving an 80mm gain and reducing the discrepancy to 40mm.</p></div><div><h3>Conclusion</h3><p>This case demonstrates a novel strategy for managing periprosthetic fractures during limb lengthening with intramedullary magnetic nails. By integrating the nail's proximal screw with a fixation plate, we enabled continued lengthening therapy and minimized additional surgical interventions. This approach underscores the need for further research to establish standardized protocols for managing such complications.</p></div>","PeriodicalId":100818,"journal":{"name":"Journal of Orthopaedic Reports","volume":"4 2","pages":"Article 100439"},"PeriodicalIF":0.0,"publicationDate":"2024-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773157X24001346/pdfft?md5=1eedda22e210ccba17b2cb755849de6a&pid=1-s2.0-S2773157X24001346-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142049914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Subchondral insufficiency fracture in the non-weight-bearing portion of the lateral femoral condyle treated with total knee arthroplasty","authors":"Hideo Kobayashi ,&nbsp;Yasushi Akamatsu ,&nbsp;Ken Kumagai ,&nbsp;Yutaka Inaba","doi":"10.1016/j.jorep.2024.100440","DOIUrl":"10.1016/j.jorep.2024.100440","url":null,"abstract":"<div><h3>Background</h3><p>We aimed to report an unusual case of a subchondral insufficiency fracture that occurred at the non-weight-bearing portion of the lateral posterior femoral condyle (LPFC).</p></div><div><h3>Case presentation</h3><p>An 82-year-old woman with severe knee pain was diagnosed with a subchondral bone defect in the non-weight-bearing portion of the LPFC. The patient underwent total knee arthroplasty with an intramedullary stem and an augmentation block. Twelve months post-operatively, her Knee Society score and knee injury and osteoarthritis outcome score improved from 34 to 92 and 136 to 316, respectively. Reports on subchondral insufficiency fractures at the portion are extremely limited. No surgical treatments or histological reports on subchondral insufficiency fractures at the portion have been published.</p></div><div><h3>Conclusions</h3><p>In our case, pre-operative valgus alignment and a combination of factors, including sex, low bone mineral density and physical activity, and lifestyle, might have resulted in the subchondral insufficiency fracture at the location.</p></div>","PeriodicalId":100818,"journal":{"name":"Journal of Orthopaedic Reports","volume":"4 2","pages":"Article 100440"},"PeriodicalIF":0.0,"publicationDate":"2024-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773157X24001358/pdfft?md5=0b526eb5b8a08eaa250bce729a53e363&pid=1-s2.0-S2773157X24001358-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142049915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A low energy paediatric medial third clavicle fracture with intrapulmonary displacement – A case report","authors":"Wei Zhang,&nbsp;Kevin Boon Leong Lim,&nbsp;Mohammad Ashik Zainuddin,&nbsp;Arjandas Mahadev,&nbsp;Kenneth Pak Leung Wong","doi":"10.1016/j.jorep.2024.100438","DOIUrl":"10.1016/j.jorep.2024.100438","url":null,"abstract":"<div><p>Medial clavicle fractures are rare in children and adolescents and complications are even less common. We present a rare case of a low energy medial third clavicle fracture in an adolescent, complicated by pulmonary perforation and persistent intrapulmonary displacement of the distal fragment. We treated this injury with chest tube insertion followed by open reduction and plating of the fracture with good outcome. The child was minimally symptomatic on presentation and the severity of the injury was picked up only on computed tomography (CT) imaging. We recommend CT imaging be performed for inferiorly displaced clavicle fractures, especially of the medial end.</p></div>","PeriodicalId":100818,"journal":{"name":"Journal of Orthopaedic Reports","volume":"4 2","pages":"Article 100438"},"PeriodicalIF":0.0,"publicationDate":"2024-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773157X24001334/pdfft?md5=ec6a8349709cdfa02888b9d0c400ba2f&pid=1-s2.0-S2773157X24001334-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142049913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"“Comprehensive assessment of Anterior Cruciate Ligament (ACL) reconstruction outcomes: Insights from a tertiary sector hospital”","authors":"Muhammad Irfan Rajput ,&nbsp;Muhammad Waqas Khan ,&nbsp;Shayan Ali Irfan ,&nbsp;Adeel Ahmed Siddiqui ,&nbsp;Anusha Ashkar ,&nbsp;Taimoor Ali ,&nbsp;Sajjad Ahmed ,&nbsp;Asif Ali ,&nbsp;Shahrukh Ahmed ,&nbsp;Jaazba Qamar","doi":"10.1016/j.jorep.2024.100426","DOIUrl":"10.1016/j.jorep.2024.100426","url":null,"abstract":"<div><h3>Purpose</h3><p>This study aims to evaluate the adherence of orthopedic surgeons towards the BOAST and Rehabilitation guidelines for the diagnostic, surgical, and rehabilitation in the management of ACL injury.</p></div><div><h3>Methods</h3><p>The clinical audit included 82 patients who had ACL reconstruction from August 1, 2018 to October 31, 2023. The retrospective data was collected for the clinical assessment, MRI timing, meniscus repair considerations, graft selection, and adherence to the rehabilitation guidelines to assess the adherence to the ACL reconstruction protocol provided by the BOAST and rehabilitation guidelines.</p></div><div><h3>Results</h3><p>Prompt clinical assessments were observed, however, variability in MRI timings indicates concerns in the standard protocol. Meniscal repair considerations were present in 70.73 % of cases. Patient involvement in graft selection discussions favored the quadruple hamstring graft. Positive early-phase outcomes in Rehabilitation Protocol were noted, but non-compliance in later stages poses a significant challenge.</p></div><div><h3>Conclusion</h3><p>The results showed adherence towards diagnostics methods, surgical interventions, and early rehabilitation, however, patient non-compliance after phase I was a major concern and requires special attention to addressing factors like patient education and socioeconomic barriers is crucial for comprehensive care.</p></div>","PeriodicalId":100818,"journal":{"name":"Journal of Orthopaedic Reports","volume":"4 3","pages":"Article 100426"},"PeriodicalIF":0.0,"publicationDate":"2024-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773157X24001218/pdfft?md5=6856cc7056dcd52ae1f87cb6b7bb3b19&pid=1-s2.0-S2773157X24001218-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142050438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A case study of septic arthritis presenting as hip and elbow pain in a pediatric patient with a rare complication","authors":"João Pedro Gomes Reis,&nbsp;Marta Dias,&nbsp;André Guimarães,&nbsp;Sara Neves,&nbsp;António Lopes","doi":"10.1016/j.jorep.2024.100427","DOIUrl":"10.1016/j.jorep.2024.100427","url":null,"abstract":"","PeriodicalId":100818,"journal":{"name":"Journal of Orthopaedic Reports","volume":"4 3","pages":"Article 100427"},"PeriodicalIF":0.0,"publicationDate":"2024-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773157X2400122X/pdfft?md5=5a1a324b82fca15fc109d253332f7534&pid=1-s2.0-S2773157X2400122X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142050439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Giant cell tumour of talus managed by excision and reconstruction by allogenic talus: A rare case report and a surgical Technique","authors":"Rahul Karn,&nbsp;Anil Regmi,&nbsp;Bishwa Bandhu Niraula,&nbsp;Parshwanath Bondarde,&nbsp;Vikas Olkha,&nbsp;Hawaibam Nongdamba,&nbsp;Vikas Maheshwari,&nbsp;Mohit Dhingra","doi":"10.1016/j.jorep.2024.100437","DOIUrl":"10.1016/j.jorep.2024.100437","url":null,"abstract":"<div><h3>Background</h3><p>A giant Cell tumour is a benign primary bone neoplasm that most often occurs in a periarticular location and typically involves the epiphyseal region of long bones. Foot involvement is rare, and isolated involvement of talus is even rarer.</p></div><div><h3>Case presentation</h3><p>Here we report a case of a Campanacci grade 3 giant cell tumour of talus in an 18-year-old female, treated with en-bloc excision by a single incision and reconstruction by ankle and subtalar arthrodesis by allogenic talus.</p></div><div><h3>Discussion and conclusion</h3><p>En bloc excision by a single incision and reconstruction by ankle and subtalar arthrodesis is a feasible option in the management of GCT of the talus. Anatomical reconstruction of the talus to fill the defect created and pan talar arthrodesis can be considered as a biological reconstruction method after excising the tumour.</p></div><div><h3>Level of evidence</h3><p>V.</p></div>","PeriodicalId":100818,"journal":{"name":"Journal of Orthopaedic Reports","volume":"4 2","pages":"Article 100437"},"PeriodicalIF":0.0,"publicationDate":"2024-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773157X24001322/pdfft?md5=df459e4324722d88cbeeb4cd1b7011e8&pid=1-s2.0-S2773157X24001322-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142047971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Demographic analysis of academic orthopaedic oncologists in the United States","authors":"Amanda Mener ,&nbsp;Gokul Kalyanasundaram ,&nbsp;Matthew R. DiCaprio","doi":"10.1016/j.jorep.2024.100436","DOIUrl":"10.1016/j.jorep.2024.100436","url":null,"abstract":"<div><h3>Importance</h3><p>This information may help guide education and recruitment efforts of fellowship directors and societies. It may also help orthopaedic surgical residents considering orthopaedic oncology.</p></div><div><h3>Objective</h3><p>The purpose of this study was to characterize the demographics, education, professional activities, and location of practice of all academic orthopaedic oncologists in the United States.</p></div><div><h3>Design</h3><p>Academic orthopaedic oncologists affiliated with orthopaedic residency programs in all fifty states, Washington D. C., and Puerto Rico were included. Demographics, education, and professional data was obtained from orthopaedic program faculty websites and Doximity profiles. Current Musculoskeletal Tumor Society (MSTS) committee membership was determined based on the MSTS website.</p></div><div><h3>Setting</h3><p>academic medical center, tertiary referral center.</p></div><div><h3>Participants</h3><p>not applicable.</p></div><div><h3>Results</h3><p>250 orthopaedic oncologists affiliated with 202 residency and fellowship programs were included. 18.8 % (47) of all orthopaedic oncologists and 18.2 % (16 of 88) of orthopaedic oncology directors were female. While female representation in orthopaedic oncology was not different from female representation among academic orthopaedic surgeons (20.5 %) (p &gt; 0.05; Chi-Square test), it was higher than female representation among all orthopaedic surgeons (5.8 %) (p &lt; 0.0001; Chi-square test). Of 71 (28.4 %) academic orthopaedic oncologists who completed an additional orthopaedic fellowship, 26.8 % (19) trained in adult reconstruction, 16.9 % (12) trained in pediatrics, and 16.9 % (12) trained in trauma. 19.6 % (49) of academic orthopaedic oncologists were actively involved in MSTS committees. States with the most academic orthopaedic oncologists included New York (30), California (21), and Texas (19). There were nine states with two academic orthopaedic oncologists, nine states with one academic orthopaedic oncologist, and eight states with no orthopaedic oncologists.</p></div><div><h3>Conclusion</h3><p>Female representation in orthopaedic oncology was similar to female representation across all academic orthopaedic surgeons. Many orthopaedic oncologists complete additional fellowship training. Orthopaedic oncologists are not distributed evenly across the US, which may lead to disparate access and discrepancies in orthopaedic oncological volume for each surgeon.</p></div>","PeriodicalId":100818,"journal":{"name":"Journal of Orthopaedic Reports","volume":"4 3","pages":"Article 100436"},"PeriodicalIF":0.0,"publicationDate":"2024-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773157X24001310/pdfft?md5=b4c5d9fd1da201fb55f4ad35ba1429c5&pid=1-s2.0-S2773157X24001310-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142047982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vascular injuries and complications in orthopedic surgery procedures","authors":"Mohammed Al-Rumaih ,&nbsp;Fahad Al-Jaber ,&nbsp;Nabil Batheeb","doi":"10.1016/j.jorep.2024.100435","DOIUrl":"10.1016/j.jorep.2024.100435","url":null,"abstract":"<div><p>Despite being seen less frequent in orthopedic surgery; vascular complications pose serious problems as there is a potential life-threatening significance. This review article discusses the complications and vascular injuries that can be seen during orthopedic surgical operations. Focal points include knee surgeries, hip arthroplasty and spinal procedures particularly associated with the popliteal artery. A crucial difference includes the categorization of anatomical injuries as spontaneous versus iatrogenic that span various complications such as arteriovenous fistulas, – deep vein thrombosis and pseudoaneurysms. The diversity in prevalence due to demographic differences, notably among trauma patients, emphasizes the requirement for customized preventive strategies. This is detected with diagnostic accuracy guided by computed tomography angiography and Advanced Trauma Life Support (ATLS) principles to ensure timely or accurate identification. Treatment modalities, open and endovascular interventions embrace complications as per their individual nature. This brief investigation underscores the requirement for ongoing vigilance, emerging diagnostic modalities and cooperative approaches all contributing to improved patient outcomes in orthopedic surgery.</p></div>","PeriodicalId":100818,"journal":{"name":"Journal of Orthopaedic Reports","volume":"4 2","pages":"Article 100435"},"PeriodicalIF":0.0,"publicationDate":"2024-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773157X24001309/pdfft?md5=0ded2a77a7fe7b283729455cc9b7d571&pid=1-s2.0-S2773157X24001309-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142049001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing medicare Advantage trends in lumbar spine surgery: Balancing financial Appeal vs patient outcomes","authors":"Hania Shahzad ,&nbsp;Muhammad Talal Ibrahim ,&nbsp;Hai Le ,&nbsp;Yashar Javidan ,&nbsp;Frank Phillips ,&nbsp;Safdar N. Khan","doi":"10.1016/j.jorep.2024.100434","DOIUrl":"10.1016/j.jorep.2024.100434","url":null,"abstract":"<div><h3>Aims &amp; objectives</h3><p>To assess coverage trends and demographic characterization of patients opting for Medicare Advantage (MA) plans and its impact on 90-day complications risks in patients undergoing lumbar fusion surgery.</p></div><div><h3>Material &amp; methods</h3><p>This study utilized the Pearldiver database, Mariner161Ortho dataset, containing de-identified patient records from 01/01/2010–10/31/2022. Patient records for primary lumbar fusion procedures in patients aged 65 and above were retrieved, and were categorized into traditional medicare (TM), MA, and other plans. Outcomes included an assessment of the trends of utilization, demographic characterization of patients and their comorbidities, and 90-day post-operative complications risks. Statistical analysis involved T-tests, chi-square tests, and multivariable regression, with significance defined as a p-value &lt;0.05.</p></div><div><h3>Results</h3><p>A total of 270,300 records were retrieved [TM (134,224 or 49.66%), MA (109,015 or 40.33%), and other plans (27,061 or 10.01%)]. MA utilization increased substantially (24.13%–47.99%), while TM cases declined (55.63%–43.26%). Demographic characterization showed that MA patients, compared to TM, were utilized by a higher percentage of men, with higher Elixhauser Comorbidity Index (ECI) scores, greater average reimbursement, and higher mean family income. Furthermore, all comorbidities were significantly more prevalent in the MA group. In terms of complications, MA plans demonstrated an increased risk of 90-day wound-related, medical, neurological, and long-term complications.</p></div><div><h3>Conclusion</h3><p>While MA plans may appear attractive for patients considering lumbar fusion surgery, spine surgeons need to thoroughly assess and discuss with patients the 90-day complication risks associated with MA coverage.</p></div>","PeriodicalId":100818,"journal":{"name":"Journal of Orthopaedic Reports","volume":"4 2","pages":"Article 100434"},"PeriodicalIF":0.0,"publicationDate":"2024-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773157X24001292/pdfft?md5=97348e13c8aa057753307a4880419871&pid=1-s2.0-S2773157X24001292-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142047970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment of tibial intramedullary osteomyelitis using removable antibiotic coated cement rods and an adipofascial perforator flap: A case report","authors":"","doi":"10.1016/j.jorep.2024.100431","DOIUrl":"10.1016/j.jorep.2024.100431","url":null,"abstract":"<div><p>Intramedullary osteomyelitis in diabetic patients yields a poor prognosis. These conditions frequently can lead to major amputation due to the complex nature of the pathology and limited effective treatment options. Here, we present our limb salvage plan in a 63 year old female suffering from an equinovarus right ankle which was complicated by wound dehiscence and intramedullary osteomyelitis following an ankle and subtalar arthrodesis.</p><p>Our treatment plan involved the use of multiple temporary antibiotic coated cement rods and an adipofascial posterior tibial artery perforator turndown flap. Our technique utilized a hybrid of the short term use of PMMA beads with the stability of a rod in a removable antibiotic coated rod with a post that allowed for biweekly rod replacement while maintaining high concentrations of antibiotic. The use of a perforator flap allowed a wider degree of freedom regarding the size and shape of the graft. It also preserved the vascularity of the graft which promoted antibiotic delivery and healing to the defect. The combination of multiple limb salvage techniques allowed for eradication of infection while providing vascularized soft tissue coverage and a functional plantigrade foot.</p></div>","PeriodicalId":100818,"journal":{"name":"Journal of Orthopaedic Reports","volume":"4 2","pages":"Article 100431"},"PeriodicalIF":0.0,"publicationDate":"2024-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773157X24001267/pdfft?md5=36ccdc81498d0a3911dad10fffbe4e1b&pid=1-s2.0-S2773157X24001267-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141398873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}