Journal of Orthopaedic Case Reports最新文献

{"title":"Intramedullary Fibular Nail Fixation in an Elderly Patient with a Comminuted Weber C Ankle Fracture: A Case Report.","authors":"Ajith Kumar Kannan, Anisha Tyagi, Johnny Dong, Elias Logothetis, Jay Bhuta, Rahul Mittal","doi":"10.13107/jocr.2025.v15.i06.5668","DOIUrl":"10.13107/jocr.2025.v15.i06.5668","url":null,"abstract":"<p><strong>Introduction: </strong>Ankle fractures are among the most common lower extremity injuries, accounting for approximately 9% of all fractures. Various methods exist for the internal fixation of fibular fractures, with open reduction and internal fixation using plates and screws currently regarded as the gold standard. However, plate and screw fixation is highly invasive and may lead to significant post-operative complications. Intramedullary (IM) nails, offering a less invasive alternative, have conventionally been indicated for non-comminuted Weber B and C fractures. To our knowledge, this is one of the few reports in the literature demonstrating the successful application of IM nails in a comminuted Weber C fracture.</p><p><strong>Case report: </strong>We describe an 80-year-old female of Caucasian descent who presented with a comminuted Weber C ankle fracture following a fall. The patient was treated with fibular nail fixation, a minimally invasive technique that achieved successful alignment and stabilization. The patient had an uneventful recovery with no post-operative complications, highlighting the potential of this method in managing complex fractures in elderly patients with comorbidities.</p><p><strong>Conclusion: </strong>This case underscores the versatility and efficacy of IM nails in treating complex fibular fractures, including comminuted Weber C fractures. It highlights the clinical relevance of this technique as a less invasive and complication-reducing alternative to traditional plating systems, particularly for elderly patients with high surgical risks. The findings suggest that IM fixation has the potential to significantly advance fracture management strategies and reduce associated morbidity.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 6","pages":"68-73"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12159630/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302337","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":"Transphyseal Separation of Distal Humerus Extending to the Lateral Condyle Mimics Isolated Lateral Condyle Fracture in Children: A Case Report.","authors":"Kalyan Deepak Sreenivas, Vineet Thomas Abraham, Muni Srikanth Iytha, Praveen Goutham, Ashish Kumar, Rambabu Lavudi","doi":"10.13107/jocr.2025.v15.i06.5652","DOIUrl":"10.13107/jocr.2025.v15.i06.5652","url":null,"abstract":"<p><strong>Introduction: </strong>The most common injuries around the elbow are the supracondylar humerus, followed by lateral condyle fractures. Transphyseal separations are uncommon, especially in children older than 3 years. Type 3 Weiss lateral condyle fractures appear similar to transphyseal separations on standard radiographs but have articular incongruity and may need open reduction. In comparison, transphyseal separations often need only closed reduction.</p><p><strong>Case report: </strong>We present a case of injury of the distal humerus in a 4-year-old child sustained due to a fall on the outstretched hand.Diagnoses, Treatment and Outcome: Transphyseal Separation and Lateral condyle humerus fractures were the differential diagnoses. The patient was treated with closed reduction and lateral pinning. The child had complete pain-free movements at the elbow at 3 and 12 months follow-up. With the help of the case report, we describe the importance of intraoperative post-reduction arthrograms to differentiate type 1, type 2 Weiss lateral condyle, and transphyseal separations from type 3 Weiss lateral condyle fractures.</p><p><strong>Conclusion: </strong>Transphyseal separation of the distal humerus can mimic lateral condyle fracture in children. Proper pre-operative radiographs and intraoperative arthrogram can avoid unnecessary open reduction and complications. This article presents a flowchart to help make a better decision regarding management.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 6","pages":"29-33"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12159655/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302369","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":"Necrotizing Fasciitis Caused by Gas-producing Methicillin-sensitive Staphylococcus aureus: A Case Report.","authors":"Travis S Bullock, Zachary Jodoin, Samuel S Ornell, Nicolas A Morton-Gonzaba, Ravi A Karia, Case W Martin","doi":"10.13107/jocr.2025.v15.i06.5712","DOIUrl":"10.13107/jocr.2025.v15.i06.5712","url":null,"abstract":"<p><strong>Introduction: </strong>It is well known that diabetic patients have impaired wound healing, increased susceptibility to infection, and harbor tissue that supports the growth of gas-producing infections. Necrotizing fasciitis (NF) is an uncommon soft-tissue infection characterized by extensive necrosis of subcutaneous tissue and fascia with relative sparing of the skin and muscle tissues. The majority of gas-producing infections are polymicrobial in nature, and therefore, NF with Staphylococcus aureus as a single etiologic agent is exceedingly uncommon.</p><p><strong>Case report: </strong>This is a case of a 46-year-old male that developed gas-forming NF and abscesses from methicillin-sensitive S. aureus (MSSA) after a complicated course involving undiagnosed type 2 diabetes mellitus (T2DM), diabetic ketoacidosis, and bacteremia. The disease course presented relatively slowly with mild systemic symptoms, knee pain, erythema, and edema, but steadily progressed over days leading to an elevated level of care. Multidisciplinary care was necessary to treat the patient, including surgical and intravenous antibiotic therapies. The patient's care was prolonged due to decreased patient compliance with recommended therapies and difficulty with appropriate shared decision-making.</p><p><strong>Conclusion: </strong>Although NF caused by monomicrobial infection with methicillin-resistant S. aureus has been previously reported, awareness of this condition remains limited, especially with concomitant gas formation. Physicians should have a high index of suspicion for NF with MSSA as a potential etiologic agent when treating patients with symptoms of a necrotizing soft-tissue infection, particularly those with underlying T2DM or a history of recent needle puncture. By engaging in shared decision making, health outcomes in these serious infections can be optimized.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 6","pages":"190-196"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12159648/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302343","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":"Reconstruction of the Proximal Portion of the Brachial Triceps Muscle with Homologous Graft: A Case Report.","authors":"Eduardo Borges Ferreira, Daniel Yiteh Lin, Maria Mascarenhas, Beatriz Lassance, Luciana Andrade da Silva, Alberto Naoki Miyazaki","doi":"10.13107/jocr.2025.v15.i06.5706","DOIUrl":"10.13107/jocr.2025.v15.i06.5706","url":null,"abstract":"<p><strong>Introduction: </strong>Injuries to the brachial triceps (BT) tendon are rare, accounting for about 1% of all tendon injuries. The complexity of these injuries, especially in their proximal portion, and the scarcity of data in the literature make each case essential to expand knowledge. This report demonstrates an effective treatment method for extensive muscle loss around the shoulder using a homologous graft, offering new perspectives for similar cases.</p><p><strong>Case report: </strong>A 65-year-old female patient presented with a history of desmoid tumor treated surgically through an extensive surgical resection of the proximal portion of the BT muscle, followed by a third-degree burn in the left scapular region. The patient exhibited sequelae, manifesting complaints related to esthetics and reduced active extension of the elbow. Hypotrophy of the deltoid muscle was also observed, associated with paresthesia in the corresponding C5 dermatome. The patient underwent surgical treatment for reconstruction of the proximal portion of the BT muscle using a homologous graft from the tensor fascia lata muscle, which resulted in esthetic and functional improvements without additional neurological deficits.</p><p><strong>Conclusion: </strong>The case report demonstrates that reconstruction of the proximal portion of the BT muscle with a homologous graft is a promising approach for treating this type of injury, bringing significant improvements in muscle function and esthetics. Furthermore, a multidisciplinary approach, postoperative surveillance, and the continuous pursuit of technical advancements are essential to optimize results and minimize complications, broadening therapeutic options in complex cases.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 6","pages":"174-179"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12159646/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302362","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":"Spinous Process Osteotomy for High Lumbar Disc Disease - An Alternative for Transforaminal Lumbar Interbody Fusion in Young- A Case Report.","authors":"Naveenkumar Kuppan, Raja Velayudham, Sathyanarayanan Parthasarathy, Pragash Mohanen","doi":"10.13107/jocr.2025.v15.i06.5648","DOIUrl":"10.13107/jocr.2025.v15.i06.5648","url":null,"abstract":"<p><strong>Introduction: </strong>The spinal canal is narrower in the upper lumbar levels than in the lower lumbar levels. Due to these reasons, the selection of a surgical approach is challenging. Fenestration discectomy at this level is more prone to neurological injury in most cases. Wide laminectomy or transforaminal approach is commonly used in upper lumbar disc surgeries. Surgical procedures using wide laminectomy and facetectomy give wide decompression but cause instability and need surgical fusion in most cases. We discuss an alternative approach for high lumbar disc disease using spinous process osteotomy, where minimally invasive non-fusion spine surgery is done with the preservation of posterior spinal elements.</p><p><strong>Case report: </strong>A 38-year-old male presented with low backache and weakness of bilateral lower limbs for 2 weeks after lifting a heavy object. He also complained of bowel and bladder incontinence. Radiographs show L2-L3 disc space narrowing with no sign of instability in dynamic views. MRI showed an L2-L3 disc bulge with an extruded disc fragment compressing the central canal. Since the patient was young, to avoid fusion and adjacent segment disease, we planned for L2-L3 discectomy using a minimally invasive spinous process osteotomy approach. During the post-operative period, there was significant improvement in motor power and bowel and bladder control. The patient was mobilized from day 01 with support. With 1 year of follow-up, the patient is pain-free and has returned to his routine activities. Follow-up X-ray of the patient shows no sign of instability.</p><p><strong>Conclusion: </strong>Spinous process osteotomy also minimizes tissue injury by preserving the paraspinal musculature and the interspinous, supraspinous ligament complex, and facets. Spinous process osteotomy is a modality of treatment for high lumbar disc disease in young patients without the need for spinal fusion.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 6","pages":"19-23"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12159633/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302364","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":"Can a Traumatic Pipkin Fracture - Dislocation and Ipsilateral Knee Dislocation Occur Simultaneously? A Rare Case Report with Mid-Term Follow-Up.","authors":"R Ragunath, K Tarun Prashanth, M R Thirunthaiyan, R Dorai Kumar, B Sundararaja","doi":"10.13107/jocr.2025.v15.i06.5694","DOIUrl":"10.13107/jocr.2025.v15.i06.5694","url":null,"abstract":"<p><strong>Introduction: </strong>Simultaneous ipsilateral hip and knee dislocations are extremely rare, especially when associated with fractures, and present significant challenges in diagnosis and management. These injuries, often resulting from high-velocity trauma, require prompt intervention to tackle the complications and achieve a good outcome.</p><p><strong>Case report: </strong>We present the case of a 28-year-old male who sustained an ipsilateral hip fracture dislocation and knee dislocation following a high-velocity road traffic accident. Initial clinical examination revealed significant deformities in both joints, and imaging confirmed posterior dislocation of the hip with an acetabular wall fracture and a posterior knee dislocation with an inferior pole patella fracture. Emergency closed reduction was performed within hours of the incident, followed by detailed imaging studies including computed tomography and magnetic resonance imaging. Surgical management involved open reduction and internal fixation of the femoral head and posterior acetabular wall reconstruction. Post-operative rehabilitation focused on joint mobility and strength, and the patient achieved full weight-bearing and near-complete range of motion by 18 months.</p><p><strong>Discussion: </strong>The rare occurrence of simultaneous hip and knee dislocations necessitates careful management, with emphasis on early reduction and neurovascular assessment. This case highlights the challenges of managing such injuries, including the coordination of hip and knee reduction techniques and post-operative rehabilitation tailored to the patient's needs. Despite the complexity, timely intervention and individualized care can lead to favorable outcomes, even in severe trauma.</p><p><strong>Conclusion: </strong>Ipsilateral hip and knee dislocations require urgent diagnosis and a multidisciplinary approach for optimal management. Prompt closed reduction, appropriate surgical intervention, and a tailored rehabilitation protocol are key to achieving good functional outcomes in these rare and complex injuries.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 6","pages":"141-147"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12159636/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302319","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":"Total Knee Arthroplasty following Genicular Artery Embolization: A Case Report.","authors":"G Varun Prasad, Mohammad Salil, Jai Thilak","doi":"10.13107/jocr.2025.v15.i06.5688","DOIUrl":"10.13107/jocr.2025.v15.i06.5688","url":null,"abstract":"<p><strong>Introduction: </strong>The literature on total knee arthroplasty following genicular artery embolization (GAE) is still in its early stages. This case highlights the challenges and essential considerations in performing total knee arthroplasty for advanced osteoarthritis (OA) in patients who experience inadequate pain relief following GAE.</p><p><strong>Case report: </strong>A patient with advanced OA underwent GAE for knee pain. He had swelling and skin discoloration around the knee, which required readmission. The patient sought further treatment options due to persistent knee pain. After a thorough pre-operative vascular assessment, he underwent total knee arthroplasty. At 1-year follow-up, he reported significant pain relief, improved knee range of motion, and returned back to daily routine activities.</p><p><strong>Conclusion: </strong>This case illustrates that after GAE for OA, with no pain relief, a successful total knee arthroplasty can be performed after comprehensive pre-operative workup with counselling on GAE issues.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 6","pages":"126-130"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12159615/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302367","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":"Evaluation of Efficacy of Tranexamic Acid on Blood Loss in Surgically Managed Intertrochanteric Fractures.","authors":"Pradyumna K Majumdar, Goutam Goyal, Virender Kumar, Rajsingh Potalia, Sirshendu Roy, Piyush Punia","doi":"10.13107/jocr.2025.v15.i06.5740","DOIUrl":"10.13107/jocr.2025.v15.i06.5740","url":null,"abstract":"<p><strong>Introduction: </strong>Intertrochanteric (IT) fracture surgeries make up a significant portion of trauma operations worldwide. The routine use of tranexamic acid (TXA) for these surgeries is not common in current practice at most places. This prospective study evaluated its efficacy in reducing perioperative blood loss and accentuating its potential for a better outcome.</p><p><strong>Materials and methods: </strong>A total of 100 patients were divided equally into two groups, A and B. Group A was given preoperative intravenous (IV) TXA and intraoperative topical TXA through the drain, while Group B was given preoperative and intraoperative normal saline. Both groups were comparable in age, body mass index, preoperative hemoglobin (Hb), surgery performed, and duration of surgery.</p><p><strong>Results: </strong>The mean drain volume, postoperative Hb, fall of Hb, and total blood loss were all significantly less in Group A as compared to Group B (P < 0.01). None of the patients in either group received more than one unit of blood transfusion. No complications were seen in any of the patients till the final follow-up.</p><p><strong>Conclusion: </strong>In comparison to other studies, our study is in agreement that TXA overall helps in blood conservation; however, our study is unique in the way that the combination of preoperative IV and intraoperative topical TXA has resulted in the best possible results.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 6","pages":"287-293"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12159644/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302328","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":"Ilizarov-Assisted Reduction of Femoral Condyle Locked in Tibial Fracture: A Case Report.","authors":"Anteshwar Birajdar, Sushant Kumar, Setu Kaneria, Archit Gupta, Omkar Shinde, Sagar Gurnani","doi":"10.13107/jocr.2025.v15.i06.5674","DOIUrl":"10.13107/jocr.2025.v15.i06.5674","url":null,"abstract":"<p><strong>Introduction: </strong>Tibial plateau fractures are commonly managed using open reduction and internal fixation (ORIF) techniques. However, external fixation through minimally invasive methods has emerged as an excellent alternative, especially for complex fracture patterns. This study focuses on evaluating the clinical and radiological outcomes of Schatzker type V tibial plateau fractures treated using the Ilizarov external fixator, highlighting its safety, effectiveness, and potential advantages over traditional approaches.</p><p><strong>Case report: </strong>A 38-year-old male presented to the emergency department following a road traffic accident, complaining of acute pain and tenderness over his left knee, which had persisted for 12 h. Radiographic examination revealed a left tibial plateau fracture classified as Schatzker type V. Given the complexity of the fracture, the Ilizarov external fixator was selected as the treatment method. The procedure aimed to achieve stable fixation while minimizing soft-tissue damage, promoting early mobilization, and reducing the risk of complications.</p><p><strong>Conclusion: </strong>The Ilizarov technique proved to be a safe and effective treatment option for managing proximal tibial fractures of the Schatzker type V variety. Its minimally invasive nature is associated with low morbidity, making it a reliable alternative to traditional ORIF, especially in complex cases. The clinical and radiological evaluations confirmed satisfactory outcomes, reinforcing the utility of the Ilizarov method in complex tibial plateau fractures.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 6","pages":"86-91"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12159639/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302335","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":"An Effectiveness and Tolerability of Tapentadol Nasal Spray in Low Back Pain.","authors":"Sunil Shetty, Shikhar Singh, Sachin Kale, Jatin Pawar, Veeramreddy Ts Manohar Rayudu, Ojas Gehlot","doi":"10.13107/jocr.2025.v15.i06.5726","DOIUrl":"10.13107/jocr.2025.v15.i06.5726","url":null,"abstract":"<p><strong>Introduction: </strong>Low back pain (LBP) is one of the most prevalent musculoskeletal conditions, leading to significant disability and healthcare burden worldwide. Effective pain relief with minimal side effects is crucial for improving patient outcomes. Tapentadol, a dual-mechanism opioid with µ-opioid receptor agonism and norepinephrine reuptake inhibition, has shown potent analgesic effects. Intranasal administration is an emerging route that ensures rapid absorption and enhanced efficacy. However, limited real-world data exist on the clinical use of tapentadol nasal spray (NS) in LBP management. This study aimed to evaluate the effectiveness and tolerability of tapentadol NS in patients with LBP.</p><p><strong>Materials and methods: </strong>This investigator-initiated, retrospective, real-world, observational study analyzed data from electronic medical records of adult LBP patients ≤65 years old treated with tapentadol NS for three consecutive days. The primary endpoint was change in score on the numeric pain rating scale (NPRS). The secondary endpoints were the proportion of patients requiring rescue medicine, change in global sleep quality score, and incidence of adverse events (AEs).</p><p><strong>Results: </strong>A total of 300 patients were included in the analysis. The mean ± standard deviation NPRS pain score decreased significantly from 7.00 ± 0.80 on day 0 to 1.38 ± 0.45 on day 3, reflecting an 80.29% reduction (P < 0.001 for all changes from baseline). Notably, 99.00% of patients achieved >51% pain reduction by day 3. Similar trends were observed across different age groups and between male and female patients. Only 1.67% (5/300) of patients required rescue medication (intravenous paracetamol). A significant improvement in sleep quality (P < 0.001) was also noted. Importantly, no AEs were reported, indicating excellent tolerability of tapentadol NS.</p><p><strong>Conclusion: </strong>Tapentadol NS demonstrated significant pain reduction and improvement in sleep quality in adult patients with LBP. The therapy was well tolerated, with no reported AEs and a minimal requirement for rescue medication. These findings suggest that tapentadol NS is an effective and safe treatment option for acute LBP. Future prospective studies with a longer follow-up period and a comparative analysis with other analgesic formulations are warranted to further establish its role in LBP management.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 6","pages":"242-249"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12159653/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302302","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}