Journal of Orthopaedic Case Reports最新文献

{"title":"Fixation of Pubic and Acetabular Pathologic Fracture with Curvafix Nail and Concurrent Total Hip Arthroplasty: A Case Report.","authors":"Alex Bassil, Kier Blevins, Will Eward","doi":"10.13107/jocr.2025.v15.i02.5212","DOIUrl":"10.13107/jocr.2025.v15.i02.5212","url":null,"abstract":"<p><strong>Introduction: </strong>The pelvis is one of the most common sites for metastatic spread to bone. Ensuing pathologic fractures pose major issues to patients. Fixation becomes essential to decrease pain and allow for weight-bearing. However, the pelvis poses a unique challenge as there are certain portions like the pubis that, because of their natural curve, are not amenable to plate or screw fixation.</p><p><strong>Case report: </strong>A 76-year-old female with known bone metastases presented to clinic with right hip pain. Computed tomography (CT) of the chest, abdomen, and pelvis revealed a new lesion in the lateral superior ramus involving the medial acetabulum. She also had osteoarthritis of the hip, for which she had an upcoming total hip arthroplasty scheduled. We performed intramedullary fixation of the lesion in the lateral superior ramus with a Curvafix nail concurrently with total hip arthroplasty.</p><p><strong>Conclusion: </strong>This case report demonstrates the utilization of a Curvafix nail in the oncologic context of an anterior column acetabular fracture along with a concurrent ipsilateral total hip arthroplasty.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 2","pages":"16-21"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11823881/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433050","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 Insights into One-Year Mortality Following Proximal Femur Fracture Surgery in India.","authors":"Shivanshu Mittal, Vivek Kumar David","doi":"10.13107/jocr.2025.v15.i02.5302","DOIUrl":"10.13107/jocr.2025.v15.i02.5302","url":null,"abstract":"<p><strong>Introduction: </strong>Proximal femur fractures are a significant public health issue and a leading cause of morbidity and mortality in the elderly. It poses a remarkable burden on healthcare resources.</p><p><strong>Materials and methods: </strong>Records of patients with proximal femur fracture operated during the study period (July 01, 2017-May 31, 2020) in our institution were obtained from hospital management system and analyzed retrospectively.</p><p><strong>Results: </strong>Out of 1189 patients, 1101 met the inclusion criteria. About 66.21% were intertrochanteric, 28.52% were neck femur, and 5.26% were sub-trochanteric fractures. About 60.85% of patients were female. The mean age was 74.1 ± 9.22 years. Most injuries were domestic falls (89%) and left-sided (55%). The average delay in presentation to the hospital was 2.5 ± 6.62 days with mean length of stay being 11.34 ± 6.22 days and average pre-operative wait being 6.89 ± 3.34 days. Hypertension was the most common comorbid condition associated (45%) followed by diabetes (27%). About 4% also sustained other fractures; most common were distal end radius and proximal humerus fracture. Majority (63.7%) were operated between 3 and 7 days post-admission and the most common surgery performed was osteosynthesis with proximal femoral nail (39.69%). For mortality assessment, 34 patients died during hospital stay, 785 patients could be assessed and 282 were lost to follow-up. In-hospital mortality was 3.08%, 30-day mortality was 8.05% and 1-year mortality was 18.92%.</p><p><strong>Conclusion: </strong>An integrated multidisciplinary approach with fall prevention awareness should be promoted to decrease the overall morbidity and mortality rate.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 2","pages":"262-268"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11823883/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433313","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":"Comparative Study of Intramedullary Flexible Nailing and External Fixator Result in the Management of Fractures Tibial Shaft. (Gustilo type II, type IIIA, and type IIIB).","authors":"Susheel Kumar Soni, Sunil Patidar, Manish Bajaj, Vaibhav Mandovera","doi":"10.13107/jocr.2025.v15.i02.5310","DOIUrl":"10.13107/jocr.2025.v15.i02.5310","url":null,"abstract":"<p><strong>Introduction: </strong>Open tibial fractures, usually caused by high-energy trauma, are among the most common long-bone fractures. Clinically, the treatment of open tibial fractures remains a major therapeutic problem for surgeons because of the poor soft-tissue coverage and blood supply in the tibia, with resultant difficulties arising from infection and poor bone healing. In this study, we will assess the results of intramedullary flexible nailing and external fixators in the management of fractures shaft tibia (G.A. type II, IIIA, and IIIB).</p><p><strong>Materials and methods: </strong>Twenty-six patients who presented with open fractures of the tibial shaft type II, IIIA, and IIIB (Gustilo) were treated. We included patients of both sexes, aged between 18 and 65 years with diaphysial fractures 5 cm distal to the tibial tuberosity and at least 5 cm proximal to the tibial plafond, irrespective of fibula fracture. Thirteen patients were treated by external fixator and 13 patients by flexible intramedullary nailing and the outcomes were assessed.</p><p><strong>Results: </strong>The mean age in our study was 36 years for the flexible intramedullary nailing group and 38 years for the external fixator group. Male involvement was 69.23% (18 patients) and female involvement was 30.76% (eight patients). In the present study, for external fixation mean age was 38 years (25-60), the union rate was 84.4%, the non-union rate was 16.6%, and the malunion was 33.3%, Pin track infection rate was 50%, the average time of union 27.08 weeks (26-30 weeks) and osteomyelitis is 16.6%. In the present study results for flexible intramedullary nailing, the mean age is 36 years (20-62 years), mal-union is 8.3%, pain at nail head rate is 16.6%, the average time of union is 25 weeks, and union achieved in all cases.</p><p><strong>Conclusion: </strong>Flexible intramedullary nailing is more efficacious than external fixators in the management of fractured shaft tibia (Gustilo type II, IIIA, and IIIB). The advantages observed are maintaining limb alignment and fewer serious complications, fewer operations needed, and a better range of motion of adjacent joints obtained. It reduces the hospital stay of patients and later patients can return early to work, thus minimizing psychological trauma and financial burden. Flexible intramedullary nailing has an easy learning curve. The external fixator group had more disability and difficulties in daily routine activities such as sleeping, bathing, and other social activities.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 2","pages":"289-294"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11823849/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433298","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":"Double X Configuration Screw Fixation for Middle Phalanx Fracture - A Case Report.","authors":"Mojahed Sakhnini","doi":"10.13107/jocr.2025.v15.i02.5262","DOIUrl":"10.13107/jocr.2025.v15.i02.5262","url":null,"abstract":"<p><strong>Introduction: </strong>Techniques for treating phalangeal fractures are evolving. Intramedullary screws are a trendy surgical choice that leads to optimal results. Metacarpals and proximal phalanges could tolerate two screws. We want to demonstrate that middle phalanx fractures could also be treated with double-cannulated screws.</p><p><strong>Case report: </strong>A 19-year-old patient with a middle phalanx fracture of the 4th left digit was treated with Kirschner wires leading eventually to malunion. We revised the fracture with a redo, recreating the fracture and introducing retrograde crossed-cannulated screws with excellent stability that allowed an immediate range of motion. The patient achieved union with full grip and range of motion.</p><p><strong>Conclusion: </strong>Middle phalanx fractures could be treated with two screws in a crossed configuration achieving stable fixation and obviating the proximal interphalangeal joint.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 2","pages":"146-149"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11823848/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143432461","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":"Suprapatellar Technique for Tibia Fractures: Is the Fracture Level Important?","authors":"Sunil Yadav, Gokul Kumar, Sanket Tanpure, Chintamani Keluskar, Atul Bhavsar, Sagar Kharat","doi":"10.13107/jocr.2025.v15.i02.5300","DOIUrl":"10.13107/jocr.2025.v15.i02.5300","url":null,"abstract":"<p><strong>Introduction: </strong>A frequent bone fracture in falls and auto accidents is the tibial fracture. This study is prospective observational study primary aim to assess the healing duration, alignment, lower extremity functional score, and complications associated with suprapatellar (SP) tibial intramedullary nailing (IMN) for proximal, shaft, and distal tibial fractures.</p><p><strong>Material and methods: </strong>Fifty-two patients (44 men and 8 women; mean age 46.9 years; range, 18-75 years) receiving semi-extended treatment using the SP method were included in the research. A solitary surgeon conducted SP IMN operations. Patients' genders, ages, limb sides, fracture types, and classifications were noted following a minimum of a 12-month follow-up. Analysis was done on non-union, angulation, healing duration, and fracture reduction accuracy. Clinical measures were performed using the lower extremity functional score scale.</p><p><strong>Results: </strong>In the tibia, 24 fractures occurred in the proximal third, 12 in the middle third, and 16 in the distal third. The average healing period was 7.34 months, with a range of 4-14 months. There was no statistically significant difference in healing times between the sites of the fractures (P = 0.75). There were no statistically significant variations in follow-up periods with respect to fracture locations (P = 0.62). The mean follow-up length was 15.76 months (range, 12-28 months). There was no statistically significant difference in lower extremity functional scores across the fracture site groups (P = 0.33).</p><p><strong>Conclusion: </strong>Irrespective of fracture level, the SP IM tibia nailing has comparable functional score, a lower incidence of malalignment, shorter recovery periods, and less need for open reduction for any type of extra Articular tibia shaft fracture.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 2","pages":"256-261"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11823872/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433456","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":"The Use of Platelet-Rich Plasma in the Treatment of Open Foot Injuries: A Case Series and Literature Review.","authors":"Samrat Smrutiranjan Sahoo, Mainak Roy, Mridul Biswas, Srirupa Mandal, Debraj Bhaumik, Ashutosh Sharma","doi":"10.13107/jocr.2025.v15.i02.5240","DOIUrl":"10.13107/jocr.2025.v15.i02.5240","url":null,"abstract":"<p><strong>Introduction: </strong>Open injuries of the foot pose considerable treatment challenges due to the intricate anatomy of the area and the elevated risk of complications, including infection, delayed wound healing, and chronic pain. Traditional management typically involves irrigation, debridement, and surgical techniques such as skin grafts or flaps. Despite these interventions, achieving optimal healing remains difficult, with many cases suffering from prolonged recovery and complications. As such, alternative treatments such as platelet-rich plasma (PRP) have gained attention for their potential to enhance healing outcomes.</p><p><strong>Case report: </strong>This case series presents the outcomes of several patients with open foot injuries treated with PRP as an adjunct to conventional wound care methods. In these cases, PRP was applied after standard debridement and wound-cleaning protocols. The application of PRP was associated with accelerated wound healing, a notable reduction in infection rates, and an improvement in patient-reported outcomes, including reduced pain and enhanced functional recovery when compared to traditional management alone.</p><p><strong>Conclusion: </strong>The findings from this case series suggest that PRP may offer significant benefits in the treatment of open foot injuries, particularly in terms of faster healing and reduced risk of complications. While the results are promising, larger, controlled studies are necessary to confirm the efficacy of PRP and to develop standardized treatment protocols for its use in managing such complex injuries.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 2","pages":"90-94"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11823878/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433466","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":"Four-Time Failed Subtrochanter Femur Fracture Fixation in Elderly: What's Next - A Case Report.","authors":"Bushu Harna, Anil Kapoor, Dinesh Sandal, Shivali Arya","doi":"10.13107/jocr.2025.v15.i02.5208","DOIUrl":"10.13107/jocr.2025.v15.i02.5208","url":null,"abstract":"<p><strong>Introduction: </strong>Subtrochanteric fractures are difficult fractures to manage, and a failed fixation in these fractures is a complex and challenging entities. Re-osteosynthesis and prosthesis replacement are two viable options. We present a case of four failed subtrochanter fracture fixations, managed with cementless long stem total hip replacement and augmented plate.</p><p><strong>Case report: </strong>A 68-year-old lady presented with pain and difficulty in walking for 12 years with four failed surgeries. The initial diagnosis was a subtrochanteric fracture managed with a proximal femur nail. The construct failed and was revised with a proximal femur plate. After a few years, the plate was broken and revised with the proximal femur nail again. Subsequently, the nail also failed after 3 years for which re-osteosynthesis with proximal femur nail was performed. The fixation again failed after 3 years leading to the inability to bear weight on the limb and pain. Cementless long stem total hip replacement with augmented plate along with bone grafting was performed as a one-time solution to the complexities in the management of 4 time-failed subtrochanter femur fractures. At 1 year of follow-up, the patient was walking pain-free and independently without any aid.</p><p><strong>Conclusion: </strong>Failed subtrochanter femur fracture fixation is a complex situation to manage. Re-osteosynthesis is the favored modality of treatment but prosthesis replacement is a feasible option in elderly patients. Total hip replacement provides a single solution to all the intricate problems in the management of failed subtrochanter femur fractures in the elderly.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 2","pages":"6-10"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11823853/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433170","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":"Medial Epicondyle Fracture Dislocation, Multiple Failed Reductions, and a Median Nerve Entrapment: A Case Report.","authors":"Neal Chase Farmer, Joseph Boesel, David Yatsonsky, Scott Riley, Chase Kluemper","doi":"10.13107/jocr.2025.v15.i02.5244","DOIUrl":"10.13107/jocr.2025.v15.i02.5244","url":null,"abstract":"<p><strong>Introduction: </strong>Medial epicondyle fracture dislocations are common in the pediatric population; however, they often lead to favorable patient outcomes. Rarely, the median nerve (MN) can be trapped within the joint space or fracture upon reduction. If the nerve is trapped within the fracture, the MN slowly gets compressed as the fracture heals, leading to progressive deficits in motor function and sensation. These symptoms present as a mixture of pain, numbness, weakness, and paresthesia in the distribution of the MN. Therefore, careful monitoring of the patient post-reduction is crucial in making an early diagnosis.</p><p><strong>Case report: </strong>A 9-year-old girl presented with an incarcerated MN following closed reduction of a left elbow medial epicondyle fracture after multiple reduction attempts. She presented 2 years post-injury with a healed medial epicondyle, median sensory deficits, and anterior interosseous palsy. Nerve studies showed deficits in median-innervated muscles. Operative exploration revealed the MN incarcerated within the healed fracture. Tendon transfer allowed for opposition and flexion of the thumb, index finger flexion, and composite fist formation.</p><p><strong>Conclusion: </strong>MN entrapment following medial epicondyle reduction may present as ongoing sensory changes and median innervated weakness. Electromyography and advanced imaging should be obtained expeditiously.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 2","pages":"101-105"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11823861/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433337","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":"Novel Use of Tricortical Iliac Crest Bone Allograft to Reconstruct the Lateral Tibia Plateau Articular Surface: A Case Series.","authors":"Luke Benjamin Schwartz, Matthew Kingery, Abhishek Ganta, Kenneth Egol, Sanjit Konda","doi":"10.13107/jocr.2025.v15.i02.5214","DOIUrl":"10.13107/jocr.2025.v15.i02.5214","url":null,"abstract":"<p><strong>Introduction: </strong>A tricortical iliac crest graft can be used to reconstruct the lateral proximal tibial articular surface.</p><p><strong>Methods/surgical technique: </strong>Anterior tricortical iliac crest autograft from the ipsilateral pelvis is harvested to approximate the contour of the native tibial plateau. A lateral proximal tibial locking plate is used to fix the bony construct to the surrounding native bone.</p><p><strong>Case report: </strong>Functionally, patients have been able to return to ambulation with and without an assistive device.</p><p><strong>Conclusion: </strong>Reconstruction of the joint surface with a tricortical iliac crest graft represents a novel surgical technique that may delay the need for arthroplasty and preserve bone stock for eventual knee replacement.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 2","pages":"22-27"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11823852/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433414","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":"Limb Salvage and Reconstruction of a Complex Upper Extremity Injury: A Case Report.","authors":"Christos Koukos, Mikail Chatzivasiliadis, Stylianos Kapetanakis, David Latz, S Samundeeswari, Fredy Montoya","doi":"10.13107/jocr.2025.v15.i02.5224","DOIUrl":"10.13107/jocr.2025.v15.i02.5224","url":null,"abstract":"<p><strong>Introduction: </strong>Complex upper extremity trauma poses us with significant challenges in orthopedic and reconstructive surgery due to the complex anatomy and functional importance of the extremities. These injuries are often the result of high-energy mechanisms like motor vehicle collisions, which makes their management particularly demanding. Making the decision between limb salvage and amputation in such cases requires careful consideration of multiple factors such as functionality, risk of complications, and recovery.</p><p><strong>Case report: </strong>We describe the case of a 39-year-old male who had sustained an open fracture of the elbow, avascular necrosis of the olecranon, a displaced ulna fracture, and transections of the triceps tendon and ulnar nerve. We tried to salvage the limb through planned reconstructive surgeries despite the complexity of the injuries and recommendations for amputation.</p><p><strong>Conclusion: </strong>Managing complex upper extremity trauma requires a structured approach that balances innovative techniques with effective infection control and soft-tissue reconstruction.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 2","pages":"49-54"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11823866/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433318","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}