Frontiers in Surgery最新文献

{"title":"A machine learning model for predicting postoperative complication risk in young and middle-aged patients with femoral neck fractures.","authors":"Yixin Huang, Dongze Lin, Bin Chen, Xiaole Jiang, Shanglin Shangguan, Fengfei Lin","doi":"10.3389/fsurg.2025.1591671","DOIUrl":"10.3389/fsurg.2025.1591671","url":null,"abstract":"<p><strong>Objective: </strong>Femoral neck fractures are the most common type of hip fracture, and the postoperative complications associated with these fractures significantly affect patients' quality of life and healthcare costs. The objective of this study was to develop a predictive model using machine learning (ML) techniques to assess the risk of postoperative complications in young and middle-aged patients with femoral neck fractures.</p><p><strong>Methods: </strong>We retrospectively analyzed data from 899 young and middle-aged patients with femoral neck fractures who underwent surgical treatment between September 2019 and June 2024. Key predictors affecting postoperative complications were identified through LASSO regression and multifactorial logistic regression analyses. Several machine learning (ML) models were then integrated for comparative analysis. Ultimately, the best-performing model was selected, and its interpretation was provided using SHAP values to offer a personalized risk assessment.</p><p><strong>Results: </strong>The study results indicate that intraoperative reduction quality, medial cortex comminution, fracture types, posterior tilt angle, early postoperative weight-bearing, and removal of internal fixation devices are significant predictors of postoperative complications. The logistic regression model demonstrated the best performance on the test set, with an area under the curve (AUC) of 0.906, accuracy of 0.877, sensitivity of 0.748, and specificity of 0.903. Additionally, SHAP analysis identified the seven most important features in the model, providing clinicians with an intuitive tool for risk assessment.</p><p><strong>Conclusions: </strong>This study successfully developed and validated a logistic regression-based predictive model, augmented with SHAP explanations, providing an effective tool for assessing the risk of postoperative complications in young and middle-aged patients with femoral neck fractures.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"12 ","pages":"1591671"},"PeriodicalIF":1.6,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12417505/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145039843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical characteristics and treatment for laryngeal cyst in children: a case series study.","authors":"Pei Zhou, Lili Zhong, Xiaofang Ding, Mohammd Ashkan Moslehi, Silan Liu, Li Peng, Han Huang","doi":"10.3389/fsurg.2025.1469405","DOIUrl":"10.3389/fsurg.2025.1469405","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to present a case series of pediatric laryngeal cysts and summarize their clinical characteristics and treatment outcomes.</p><p><strong>Methods: </strong>This retrospective case series study included pediatric patients with laryngeal cysts at the author's Hospital, and clinical data were analyzed.</p><p><strong>Results: </strong>A total of 20 patients were included. Among them, 15 children were diagnosed with supraglottic cysts, while five were categorized into the glottic and subglottic groups. The primary symptoms included stridor (16/20, 80%), shortness of breath (15/20, 75%), coughing after feeding (12/20, 60%), cyanosis (7/20, 35%), and Spo² < 95% (8/20). Bronchoscopy revealed single or multiple transparent or semitransparent cystic masses capable of causing varying degrees of compression of the epiglottis or airway obstruction. Thirteen children with supraglottic laryngeal cysts underwent endoscopic plasma cyst ablation, while five children in the glottic and supraglottic areas underwent bronchoscopic titanium laser ablation. Almost all patients showed significant symptom improvement after treatment. None of the other children (18/20, 90%) experienced a recurrence during the 2 to 36-month follow-up period.</p><p><strong>Conclusion: </strong>Bronchoscopy should be considered for children experiencing stridor, shortness of breath, coughing after feeding, cyanosis, and Spo² < 95%. Treatment choice between endoscopic plasma cyst ablation and bronchoscopic titanium laser ablation depends on cyst type.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"12 ","pages":"1469405"},"PeriodicalIF":1.6,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12418983/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145039847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"MIS-TLIF for a gas-containing discal cyst with adjacent -lumbar spondylolisthesis: a case report and literature review.","authors":"Haoyun Huang, Guangye Li, Junwen Deng, Rigao Chen, Yi Zhou","doi":"10.3389/fsurg.2025.1626636","DOIUrl":"10.3389/fsurg.2025.1626636","url":null,"abstract":"<p><strong>Introduction: </strong>Gas-containing lumbar disc cysts are a rare cause of neurogenic pain. These cysts typically occur in middle-aged and elderly patients and are predominantly associated with lumbar disc degeneration, presenting with sensory and motor deficits in the affected dermatomes. The prevalence remains unclear due to the limited number of reported cases. Instances involving concomitant lumbar spondylolisthesis at adjacent segments are extremely rare and poorly documented in the current literature.</p><p><strong>Case presentation: </strong>The 67-year-old woman presenting with recurrent lower back pain, numbness, and swelling in the left lower limb for over 6 months. Previous conservative treatments yielded minimal relief. DR imaging showed anterior displacement of the L4 vertebral body and reduced L5/S1 intervertebral height. CT imaging confirmed L4 anterior slippage with L4/5 segmental spinal stenosis, a disc vacuum phenomenon at L5/S1, and a gas-containing cyst at the left posterior margin of the intervertebral disc. MRI imaging revealed a low-signal area on T1-weighted imaging/T2-weighted imaging sequences at the cyst location. A preliminary diagnosis of L5/S1 gas-containing disc cyst with adjacent L4/5 spondylolisthesis was established based on comprehensive clinical assessments. And a two-segment minimally invasive transforaminal lumbar interbody fusion was performed at L4/5 and L5/S1.</p><p><strong>Result: </strong>The patient experienced significant symptom relief, with postoperative CT confirming cyst resolution, restored L5/S1 intervertebral height, and L4/5 stability. At 1-month follow-up, the patient reported minimal pain. By 3 months, lower extremity symptoms had fully resolved.</p><p><strong>Conclusion: </strong>These findings suggest that fusion surgery might be a superior treatment option for cases involving discal cysts with spondylolisthesis, particularly when clinical evidence of vertebral instability is present.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"12 ","pages":"1626636"},"PeriodicalIF":1.6,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12418982/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145039907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Post-traumatic elbow stiffness: etiology, risk factors and current treatments.","authors":"Maoqiang Fan, Fan Xu, Chen Fei, Yao Liu, Zhongtao Yang, Zhe Song","doi":"10.3389/fsurg.2025.1643326","DOIUrl":"10.3389/fsurg.2025.1643326","url":null,"abstract":"<p><p>Post-traumatic elbow stiffness is a major cause of functional impairment after elbow trauma, affecting 10%-15% of patients. A 50% reduction in elbow range of motion can lead to an 80% decline in upper limb functionality, significantly impairing work performance and social participation. Based on a systematic search of Pub Med, Web of Science, China Knowledge Net and other databases, this paper systematically reviewed the diagnosis and treatment of post-traumatic elbow stiffness. While open and arthroscopic lysis remain effective when nonoperative treatment fails, the timing of surgery and the duration of postoperative immobilization remain controversial. Early and individualized rehabilitation is critical, and future research will focus on optimizing individualized treatment protocols and multidisciplinary treatment modalities.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"12 ","pages":"1643326"},"PeriodicalIF":1.6,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12418977/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145039911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"MRI-based parameters to assess the quality and prognosis of closed reduction in toddlers with developmental dysplasia of the hip.","authors":"Jinchao Cao, Yu Li, Junzhong Luo, Zhaosu Zheng, Xuan Wang, Yunshan Su, Jiuhui Han","doi":"10.3389/fsurg.2025.1643044","DOIUrl":"10.3389/fsurg.2025.1643044","url":null,"abstract":"<p><strong>Background: </strong>Developmental dysplasia of the hip (DDH) in toddlers (9-18 months) presents unique challenges due to incomplete ossification and anatomical complexity. Traditional imaging modalities, including x-ray, CT, arthrography, and ultrasonography, have limitations in assessing reduction quality. This study introduces a novel approach using only two magnetic resonance imaging (MRI) parameters-axial acetabular femoral head distance (aAFD) and coronal acetabular cartilage head index (CAHI)-to evaluate the quality of closed reduction (CR) and identify risk factors for redislocation.</p><p><strong>Methods: </strong>We retrospectively reviewed 51 patients (58 hips) who underwent CR for DDH from June 2014 to June 2021. Pre- and post-CR pelvic radiographs assessed dysplasia grade, acetabular index (AI), and avascular necrosis (AVN). MRI, performed within three days post-CR, evaluated hip reduction quality using aAFD and CAHI. The reliability of these indices and their association with redislocation risk were analyzed.</p><p><strong>Results: </strong>The study cohort had a mean age of 13.7 ± 2.6 months and an average follow-up of 58.4 ± 13.5 months. CR was successful in 50 hips (86.2%), while 8 hips (13.8%) failed. Compared to failed cases, successful reductions showed significantly lower aAFD (2.4 ± 0.88 mm vs. 5.12 ± 1.70 mm, <i>p</i> < 0.05) and higher CAHI (83.4 ± 3.5% vs. 68.7 ± 4.9%, <i>p</i> < 0.05). AVN was observed in 10 hips (17.2%). Both aAFD and CAHI demonstrated strong intra- and interobserver reliability. ROC curve analysis showed excellent predictive accuracy for CAHI (AUC = 0.990) and aAFD (AUC = 0.968), with optimal thresholds aligning closely with the proposed cutoffs. Univariate analysis identified higher preoperative IHDI grade (<i>p</i> = 0.022) and more severe AVN (<i>p</i> < 0.01) as significant predictors of CR failure.</p><p><strong>Conclusions: </strong>Closed reduction with spica casting remains an effective treatment for DDH in toddlers. Postoperative MRI evaluation using only aAFD and CAHI offers a reliable and clinically applicable method for assessing reduction quality. Larger aAFD and lower CAHI values indicate a higher risk of reduction failure, making these indices valuable for postoperative assessment and decision-making.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"12 ","pages":"1643044"},"PeriodicalIF":1.6,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12418978/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145039888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long COVID risk factors and outcomes among solid organ transplant recipients: a retrospective cohort study.","authors":"Micaela N Sandoval, Linda W Moore, Howard J Huang, Edward A Graviss","doi":"10.3389/fsurg.2025.1602167","DOIUrl":"10.3389/fsurg.2025.1602167","url":null,"abstract":"<p><strong>Background: </strong>Solid organ transplant (SOT) recipients are not only at increased risk of morbidity and mortality due to acute COVID-19 but may also experience poor long-term outcomes due to post-acute COVID-19 syndromes, including long COVID.</p><p><strong>Methods: </strong>This retrospective, registry-based chart review evaluated graft failure and mortality among SOT recipients diagnosed with COVID-19 at a large, urban transplant center in Houston, Texas, USA. Patient populations were analyzed separately according to their long COVID status at the time of transplant to preserve the temporal relationship between the exposure (long COVID) and the outcome (graft failure or mortality).</p><p><strong>Results: </strong>In total, 146 (5%, 146/3,202) patients were diagnosed with long COVID, 443 (14%, 443/3,202) patients expired during the study period, and 202 (6%, 202/3,202) were diagnosed with graft failure. Overall, patients with long COVID were older, had an increased comorbidity burden, and were more likely to be lung, heart, or heart-lung recipients compared with those who were not diagnosed with long COVID. Long COVID was not significantly associated with death or graft failure in this study population, though relationships varied across subpopulations.</p><p><strong>Conclusions: </strong>The observed differences between patients diagnosed with COVID-19 and long COVID before and after transplant warrant additional studies as the proportion of people with some SARS-CoV-2 infection history approaches 90%. Future investigations may prioritize longitudinal follow-up of long COVID patients diagnosed before or after transplant to determine specific etiologies of long-term morbidity and mortality.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"12 ","pages":"1602167"},"PeriodicalIF":1.6,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12415067/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145029407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical efficacy comparison of internal fixation of locking compression plate and cannulated screw in treatment of elderly femoral neck fractures-a retrospective study.","authors":"Fei Sun, Yu Sun, Wei Li, Zhi Tang, Enxu Liu, Zhaoyong Li, Shaofeng Yang","doi":"10.3389/fsurg.2025.1600331","DOIUrl":"10.3389/fsurg.2025.1600331","url":null,"abstract":"<p><strong>Objective: </strong>To explore the clinical efficacy of internal fixation of locking compression plate and Cannulated Screw in treatment of elderly femoral neck fractures.</p><p><strong>Methods: </strong>175 patients with femoral neck fractures admitted to our hospital from January 2022 to December 2022 were enrolled in the study. 93 cases in the control group were treated with Cannulated Screw internal fixation, and 82 cases in the observation group were treated with locking plate internal fixation. The control group was treated with cannulated screw internal fixation, while the observation group was treated with locking compression plate internal fixation.</p><p><strong>Results: </strong>Compared with the control group, the observation group had a significantly shorter time for partial weight-bearing exercise, with a statistically significant difference (<i>p</i> < 0.05), and a significantly lower incidence of postoperative complications, with a statistically significant difference (<i>p</i> < 0.05). The ROM of hip extension-flexion at 1 month and 6 months after operation and the ROM of hip internal rotation-external rotation at 1 month after operation in the observation group were significantly higher than those in the control group, and the differences were statistically significant (<i>P</i> < 0.01). The VAS score of the observation group was significantly lower than that of the control group at 1 month after operation, and the difference was statistically significant (<i>P</i> < 0.01).</p><p><strong>Conclusion: </strong>Both locking compression plate internal fixation and cannulated screw internal fixation are effective in the treatment of elderly femoral neck fractures. Compared with cannulated screw internal fixation, locking compression plate internal fixation helps patients to engage in early functional exercise and has a lower incidence of postoperative complications.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"12 ","pages":"1600331"},"PeriodicalIF":1.6,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12414934/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145029427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultrasound- guided microwave ablation for symptomatic breast cysts: early outcomes and clinical implications.","authors":"Khanh Quang Huynh, Phat Thanh Nguyen, Khoi Van Nguyen","doi":"10.3389/fsurg.2025.1544662","DOIUrl":"10.3389/fsurg.2025.1544662","url":null,"abstract":"<p><strong>Background: </strong>Breast cysts are more common in premenopausal women (61.5%), particularly between ages 35-50. Microwave ablation (MWA) has shown advantages in treating symptomatic cysts.</p><p><strong>Objective: </strong>To evaluate early outcomes of ultrasound-guided MWA for breast cysts at the Breast Unit of Cho Ray Hospital.</p><p><strong>Methods: </strong>A retrospective review was conducted on patients who underwent MWA from August 2018 to March 2020.</p><p><strong>Results: </strong>Fifty-eight patients (mean age: 45.3) were included. Simple, complicated, and complex cysts accounted for 80.0%, 16.9%, and 3.1%, respectively. The mean cyst diameter was 23.86 mm. A size reduction exceeding 90% was observed in the ablated cyst at the 6 months follow- up, with the exception of 1 cyst with mural calcification that showed no response.</p><p><strong>Conclusion: </strong>MWA is a promising and safe treatment for symptomatic breast cysts, offering high success and low complication rates. Cyst mural calcification may affect treatment response and should be carefully assessed.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"12 ","pages":"1544662"},"PeriodicalIF":1.6,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12411521/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145014797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical outcomes of robot-assisted vs. conventional free-hand technique in spine surgery.","authors":"Hui Yan, Yuxuan Wu, Xiaokang Cheng, Chunyang Xu, Tianci Yang, Beixi Bao","doi":"10.3389/fsurg.2025.1517470","DOIUrl":"10.3389/fsurg.2025.1517470","url":null,"abstract":"<p><strong>Background: </strong>Robot-assisted surgery has been increasingly applied in spinal surgery in recent years, but the differences in efficacy compared to conventional free-hand surgery remain unclear. This study aims to evaluate the impact of these two surgical approaches on spinal surgery patients by analyzing baseline characteristics, surgical data, short-term postoperative outcomes, and long-term functional recovery and pain relief.</p><p><strong>Methods: </strong>This study first analyzed the differences in baseline characteristics and surgical data between the robot-assisted and conventional free-hand surgery groups, including age, gender, diabetes, hypertension, smoking, and alcohol consumption. Multivariate logistic regression was then used to explore the effects of baseline characteristics and surgical methods on short-term postoperative outcomes, such as complications, reoperations, fracture healing, and spinal alignment recovery. Finally, generalized estimating equations (GEE) were employed to assess the impact of surgical methods on long-term postoperative outcomes, including Oswestry Disability Index (ODI) and pain scores.</p><p><strong>Results: </strong>Diabetes and hypertension significantly increased the risk of postoperative complications and reoperation, while robot-assisted surgery significantly reduced the incidence of complications and reoperation. In terms of spinal structural recovery after surgery, the robot-assisted surgery group showed better results. Long-term follow-up revealed that robot-assisted surgery significantly reduced ODI and pain scores, and over time, the robot-assisted group consistently demonstrated superior functional recovery and pain relief compared to the conventional surgery group.</p><p><strong>Conclusion: </strong>Robot-assisted surgery showed significant advantages in both short-term postoperative recovery and long-term functional improvement and pain relief. It outperformed conventional free-hand surgery in reducing complication rates, accelerating postoperative recovery, lowering reoperation rates, and promoting fracture healing and spinal alignment recovery.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"12 ","pages":"1517470"},"PeriodicalIF":1.6,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12411553/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145014715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case Report: A case of surgical and enzyme replacement therapy for type I Gaucher disease complicating femoral shaft pathological fracture.","authors":"Yang Gao, Jia Liu, Zhijie Zhang, Xinhao Sheng, Yuerong Wang, Xin Zhao, Huanzhi Ma","doi":"10.3389/fsurg.2025.1616941","DOIUrl":"10.3389/fsurg.2025.1616941","url":null,"abstract":"<p><p>Gaucher disease (GD) is an inherited lysosomal storage disorder caused by glucocerebrosidase (GCase) deficiency. A 35-year-old male patient was admitted to our hospital due to left thigh pain and restricted mobility for 10 h. Following comprehensive evaluations, the patient was diagnosed with GD complicated by a pathological fracture of the left femur. He has a known L444P mutation, a suspected pathogenic A170H mutation, and an A271 V mutation of uncertain significance not in GD databases. However, a potential association with the disorder cannot be excluded. We speculate that the patient's marked thrombocytosis may be related to the rare A170H and A271 V mutations. After an assessment, a decision was made to perform curettage of the left femoral lesion and open reduction internal fixation (ORIF) for the fracture. Postoperative management included ongoing enzyme replacement therapy. To date, case reports of GD patients undergoing ORIF for fractures are relatively rare, and the patient in this case harbored rare A170H and A271 V mutations. We report this case with the aim of sharing experience related to internal fixation for fractures in patients with GD, summarizing the specific phenotypes presented by specific gene mutation types, and providing a basis for the subsequent discovery of new gene mutations in GD.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"12 ","pages":"1616941"},"PeriodicalIF":1.6,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12412132/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145014757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}