Journal of Orthopaedic Case Reports最新文献

{"title":"Tibial-based Posterolateral Corner Reconstruction Following Proximal Fibula Resection Restores Knee Stability: A Case Report.","authors":"Vitor Hugo Pinheiro, Pedro Marques, Kyle Borque, Rúben Fonseca, Fernando Fonseca, Andy Williams","doi":"10.13107/jocr.2025.v15.i01.5154","DOIUrl":"10.13107/jocr.2025.v15.i01.5154","url":null,"abstract":"<p><strong>Introduction: </strong>Fibular- and tibiofibular-based reconstructions are the gold standard treatment for posterolateral corner (PLC) injuries of the knee. This is the first report describing a wholly tibial-based PLC reconstruction.</p><p><strong>Case report: </strong>A 50-year-old female presented with knee instability following proximal fibular resection for a benign tumor, associated with chronic anterior cruciate ligament (ACL) deficiency from a previous injury. Magnetic resonance imaging (MRI) showed fibular collateral ligament (FCL) and distal biceps femoris complete detachment. ACL reconstruction was combined with revision PLC reconstruction, placing the distal grafts, due to lack of fibula, both into the tibia. At 24-month follow-up, the patient reported excellent clinical outcomes.</p><p><strong>Conclusion: </strong>In cases related to proximal fibula deficiency from resection or congenital causes, a wholly tibial-based PLC reconstruction can effectively restore stability.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 1","pages":"139-144"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11723759/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142971288","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":"Rare Coexistence: Giant Cell Tumor Recurrence and Infection in the Proximal Tibia - A Case Report.","authors":"Mainak Roy, Harsha Vardhan Reddy, Suhas Aradhya Bhikshavarthimath, Samir Chandrakant Dwidmuthe, Vivek Tiwari","doi":"10.13107/jocr.2025.v15.i01.5112","DOIUrl":"10.13107/jocr.2025.v15.i01.5112","url":null,"abstract":"<p><strong>Introduction: </strong>Giant cell tumor of bone (GCTB) ranks among the most prevalent locally aggressive tumor lesions, displaying a diverse range of biological behaviors. Recurrence of GCTB is well-documented, often attributed to microscopic tumour remnants remaining after intralesional curettage, with increased concern when infection occurs postoperatively. Studies suggest the limited effectiveness of adjuvants in preventing giant cell tumour recurrence, emphasizing the necessity of complete removal of malignant cells. We describe our experience with a rare presentation of recurrence together with infection in an operated case of GCTB right proximal tibia with curettage with cementing and plate stabilization.</p><p><strong>Case report: </strong>A 28 year-old female who was operated case of GCTB right proximal tibia with curettage with cementing and plate stabilization in 2020 presented to our outpatient department with complaints pain in right leg while walking for 3 months in October 2021. Plain radiography of the right knee suggestive of lytic lesion over medial aspect of the right tibia around cement with plate in situ and magnetic resonance imaging right knee suggestive of recurrence of the tumor with no breach in joint line and no involvement of neurovascular structures. The patient was planned for implant removal with extended curettage and plate stabilization and cementing with antibiotics (vancomycin and gentamycin) after sending tissues for culture sensitivity and histopathology. Intraoperative cultures showed growth of methicillin-sensitive staphylococcus aureus which was sensitive to cefoxitin, gentamicin, cotrimoxazole, and doxycycline following which pt received 2 weeks of intravenous antibiotics and 4 weeks of oral antibiotics as per culture sensitivity with no post-operative wound complications and had satisfactory functional outcome. The patient was followed at regular intervals till 2-year follow-up did not show any signs of recurrence and infection.</p><p><strong>Conclusion: </strong>The manifestation of GCTB recurrence alongside infection is exceedingly rare with limited literature evidence. Our case illustrates a method to address both issues concurrently during a single procedure, utilizing antibiotic bone cement to tackle infection and extended curettage for thorough removal of neoplastic cells from the surrounding bone.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 1","pages":"26-30"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11723728/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142971245","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 Management Approaches for Acute Distal Radioulnar Joint Instability Post distal End Radius Fracture.","authors":"Anteshwar Birajdar, Sushant Kumar, Mukesh Phalak, Tushar Chaudhari, Damarla Meghana","doi":"10.13107/jocr.2025.v15.i01.5192","DOIUrl":"10.13107/jocr.2025.v15.i01.5192","url":null,"abstract":"<p><strong>Introduction: </strong>The peripheral radioulnar articulation and the bony radioulnar articulation make up the distal radioulnar joint (DRUJ), a diarthrodial trochoid synovial joint stabilizers for soft tissues. Of the DRUJ's stability, only around 20% may be attributed to the bony articulation. Treatment for DRUJ injuries resulting from a solely ligamentous rupture varies and is subject to debate. Usually, non-operative care is coupled with occupational therapy, activity modification, brace or splint immobilization, and pain management.</p><p><strong>Aim: </strong>The aim of this study was to analyze comprehensive management approaches for acute DRUJ instability post-distal radius fracture.The key takeaway from the article is that TFCC repair may not be essential, with K-wire stabilization providing better range of motion and cast immobilization offering stronger grip, but further large-scale controlled trials are required to fully assess these treatment options in terms of patient satisfaction and functional outcomes.</p><p><strong>Materials and methods: </strong>After primary fixation of the respective fractures (distal end radius fracture or distal end ulna fracture or both) by ORIF with Plating or CRIF with K-wiring or by Traction for casting, the distal radio ulna joint instability is stabilized by casting, closed reduction internal fixation (CRIF) with K-wiring or open triangular fibrocartilage complex (TFCC) repair and the outcome is measured by grip strength, range of motion with DASH and MMWS scores by follow up and compared.</p><p><strong>Results: </strong>Between the groups, there was no discernible variation in grip strength (P > 0.05). A noteworthy variation in flexion was seen among the groups (P < 0.05). The groups' differences in extension were statistically significant (P < 0.05). Pronation did not significantly differ across the groups (P > 0.05). Supination did not differ significantly between the groups (P > 0.05). The DASH scores of the groups did not differ significantly (P > 0.05). Between the groups, there was a significant difference in MMWS (P < 0.05).</p><p><strong>Conclusion: </strong>The major findings of analysis have suggested that the time, effort, and cost of TFCC repair do not appear to be necessary, however, there may be trade-offs between various treatments, with K-wire stabilization offering a better range of motion and cast immobilization a stronger grip.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 1","pages":"254-259"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11723748/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142971309","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":"Low-Grade Myofibroblastic Sarcoma of the Acetabulum - A Rare Case with Review of Literature.","authors":"Sandeep Kumar, Vivek Bhambhu, Shataayu Gugale, Rohit Goyal, Divyank Gupta","doi":"10.13107/jocr.2025.v15.i01.5126","DOIUrl":"10.13107/jocr.2025.v15.i01.5126","url":null,"abstract":"<p><strong>Introduction: </strong>Low-grade myofibroblastic sarcoma (LGMS) is an atypical and extremely infrequent type of tumor, primary mass being usually present in subcutaneous and soft tissue. Bony involvement is very rare. It has a very high chance of recurrence locally due to its aggressive biological behavior, metastasis in other parts of body is rarely seen. On X-ray, it is visualized as an osteolytic and destructive mass. On magnetic resonance imaging (MRI) this tumor shows heterogenous high signal intensity in T2 images and hypo- to iso-intensity in T1 images. Histologically, these tumors present as diffuse, infiltrative growth pattern traversing between muscle fibers, and cellular atypia with singular mitotic figures. These are obligatory criteria for diagnosis. Due to diagnostic difficulty including histopathological limiting factors, the treatment protocol for LGMS s is still challenging.</p><p><strong>Case report: </strong>A 21-year-old female with pain in right pelvic and hip region since past 6 months presented with a diffuse swelling over her right hip, along with tenderness over greater trochanter, groin and buttock region. On basis of MRI findings, core needle biopsy was performed for diagnosis and the sample was suggestive of a spindle cell lesion composed of cells arranged in haphazard and vaguely fascicular pattern. To confirm the diagnosis immunohistochemistry marker study was done, revealing features suggestive of LGMS (smooth muscle actin: Positive, B-cell lymphoma 2: Positive.</p><p><strong>Desmin: </strong>Negative, H-caldesmon: Negative). Histomorphological and immune-histo-chemical features showed a final diagnosis of LGMS of right-sided acetabulum. Positron emission tomography -scan was done to rule out any distant metastasis, and it did not show any definitive evidence of abnormal hyper-metabolism elsewhere in the body. Pre-operative computed tomography (CT) angiography was done and plan was made to embolize the feeding vessels preoperatively using the findings of CT angiography.</p><p><strong>Conclusion: </strong>Presentation of LGMS with bone involvement or bone lesions is very rare. Clinicoradiological diagnosis be misinterpreted as a benign lesion which can lead to insufficient resection and local recurrence of the tumor. For treatment in such cases, most studies emphasize on excision of tumor with a wide surgical margin, but regarding the safety distance for better adequacy, relevant data is still inconsistent. In our case, we have reported a case of a 21-year-old female for gross total resection and reconstruction of an acetabular LGMS with extension into iliac wing. To the best of our knowledge, it is the first case of this tumor involving the acetabulum.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 1","pages":"61-66"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11723747/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142971310","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":"Metallosis, Trunnionosis, and Head-stem Dissociation of the Exeter v40 Stem in a Metal-on-Metal Hip: A Unique Case.","authors":"Sahil Shet, Kunal Mohan, Rehan Gul","doi":"10.13107/jocr.2025.v15.i01.5146","DOIUrl":"10.13107/jocr.2025.v15.i01.5146","url":null,"abstract":"<p><strong>Introduction: </strong>In this article, we report a unique case of head-stem dissociation in a metal-on-metal total hip replacement which utilized an Exeter stem. Although metallosis and pseudotumor formation are well recognized complications of metal-on-metal hip replacements, head-stem dissociations are rare with few being reported in literature. To the best of our knowledge, this case report is the first to report this occurrence in an Exeter stem.</p><p><strong>Case report: </strong>A 76-year-old male presented to the emergency department with pain and discomfort in his left hip triggered by a twisting movement while getting into bed. The patient described a \"pop\" in his hip upon turning and reported mild ongoing discomfort in his left hip for the past 4 weeks before this acute presentation. X-rays and Metal artifact reduction sequence magnetic resonance image (MARS) revealed head-stem dissociation along with pseudotumor formation. The patient successfully underwent a two stage revision with no perioperative complications.</p><p><strong>Conclusion: </strong>This case report, to the best of our knowledge, is the first to report catastrophic failure of a metal-on-metal hip caused by trunnionosis and subsequent head-stem dissociation. We report successful management of this unique case and hope to highlight the complexities and challenges associated with metal-on-metal THR. This case report is aimed at raising clinical awareness of this rare complication which requires expert management for a successful outcome.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 1","pages":"116-121"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11723720/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142971311","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":"Metastatic Neuroblastoma Masquerading as Ewing's Sarcoma on X-ray: An Imaging Puzzle in Pediatric Oncology.","authors":"Mukesh Kumar, Jitendra Sharma, Radha Sarawagi, Varun Tej, Ishudeep Kaur, Dega Vamsikrishna","doi":"10.13107/jocr.2025.v15.i01.5166","DOIUrl":"10.13107/jocr.2025.v15.i01.5166","url":null,"abstract":"<p><strong>Introduction: </strong>Neuroblastoma is an embryonic tumor of the peripheral sympathetic nervous system. It is the most common extracranial solid tumor of childhood and accounts for up to 15% of all pediatric cancer fatalities. The manifestation of neuroblastoma is variable depending on the location of the tumor and the presence or absence of paraneoplastic syndromes. Neuroblastoma has a great propensity to metastasize to multiple organs. The most common site of metastasis is the bone and bone marrow. Ewing sarcoma is a rare small round blue cell tumor originating from neuroectoderm. It is the most common primary bone tumor of adolescents. The most common anatomical sites of involvement include the pelvis, axial skeleton, and femur; however, Ewing sarcoma can occur in almost every bone or soft tissue. Here we report a primary expansile bony lesion in the left femur mimicking Ewing's sarcoma which on extensive workup was diagnosed as metastasis of adrenal neuroblastoma. This is the first report of this kind in the literature.</p><p><strong>Case report: </strong>A 3-year-old female child presented with complaints of swelling in the left thigh for 2 months. She did not have any abdominal complaints. Her initial X-ray of the thigh revealed increased density and thickness of soft tissue in the mid and distal thigh and laminated periosteal reaction with focal areas of sunburst appearance in the left femoral diaphysis region. Ultrasound (USG) of the thigh confirmed the findings of the X-ray and a provisional diagnosis of Ewing's sarcoma was considered. During the routine workup, an USG abdomen was done which revealed an infiltrating retroperitoneal mass crossing the midline, encasing the aorta and its branches. Contrast-enhanced computed tomography of the abdomen confirmed the sonographic findings that a heterogeneously enhancing mass encasing and displacing the abdominal aorta and the left kidney was noted. The left adrenal gland was not separately visualized. Based on these findings, the primary diagnosis of metastatic neuroblastoma bony metastasis was made. Histopathology and immuno-histochemistry of the left suprarenal mass confirmed the diagnosis of neuroblastoma.</p><p><strong>Conclusion: </strong>Neuroblastoma can primarily present with musculoskeletal symptoms such as expansile metastatic bony lesions or pathological fractures and should be considered in the differential diagnosis.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 1","pages":"171-176"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11723737/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142971312","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":"Analysis of Extreme Beak Calcaneal Fracture (Type 2-Lee) Fixed with Cannulated Cancellous Screws: An Original Research Article.","authors":"Vejaya Kumar, Saravanan Kasirajan","doi":"10.13107/jocr.2025.v15.i01.5200","DOIUrl":"10.13107/jocr.2025.v15.i01.5200","url":null,"abstract":"<p><strong>Introduction: </strong>Extreme beak calcaneal fractures (Type 2 Lee's tuberosity avulsion fractures) are rare injuries, accounting for only 1.3-3% of all calcaneal fractures. These injuries are considered as surgical emergency as they can lead to significant functional impairment and soft-tissue compromise if not promptly managed. This study evaluates the efficacy of cannulated cancellous (CC) screw fixation for these fractures.</p><p><strong>Materials and methods: </strong>A prospective study of 14 patients with extreme beak calcaneal fracture (Type 2 Lee's - tuberosity avulsion fractures) treated with CC screw fixation was conducted in VMMCH, Karaikal, Puducherry between June 2022 and June 2023. Patients were followed for a minimum of 12 months. Functional outcomes were assessed using the American Orthopedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot scale.</p><p><strong>Results: </strong>The mean AOFAS score at the final follow-up was 89.3 (range 78-98). Radiographic union was achieved in all cases by 20 weeks with a mean union time of 13.09 weeks in closed fractures and 18 weeks in open fractures. One patient developed a superficial wound infection without any alarming signs of hardware issues, which resolved eventually. No hardware failures or need for revision surgeries were observed.</p><p><strong>Conclusion: </strong>Early intervention with CC screw fixation appears to be an effective and safe technique for the treatment of extreme beak calcaneal fracture (Type 2 Lee's - tuberosity avulsion fractures), resulting in excellent functional outcomes and a low complication rate.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 1","pages":"279-286"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11723731/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142971285","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":"Aneurysmal Bone Cyst of Femoral Head : A Rare Case Report.","authors":"Sumedh Chaudhary, Raunak Dhawale, Sarang Sawarbandhe, Pravin Agrawal, Amit Kate, Kuber Sakhare, Nilesh Sakharkar","doi":"10.13107/jocr.2025.v15.i01.5152","DOIUrl":"10.13107/jocr.2025.v15.i01.5152","url":null,"abstract":"<p><strong>Introduction: </strong>Aneurysmal Bone Cyst (ABC) is a benign, non neoplastic, expansile lesion of bone characterized by channels of blood and spaces separated by fibrous septae. ABC of femoral head is an extremely rare condition and is difficult to treat as the surgical approach is a dilemma .</p><p><strong>Case report: </strong>We hereby report a case of aneurysmal bone cyst in femoral head of a 19 year old female patient. To preserve the vascularity of the femoral head, we approached the lesion by ganz safe surgical dislocation of the affected femoral head, trapdoor procedure of femoral head followed by curettage and bone grafting . The patient was followed up for 6 months & at latest follow up, lesion has healed completely & patient is walking pain free .</p><p><strong>Conclusion: </strong>In rare cases like ABC of femoral head, a trapdoor osteotomy of femoral head with bone grafting followed by stabilization of the bone graft and osteotomy gives excellent functional and radiological outcomes.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 1","pages":"133-138"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11723746/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142971290","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":"Evaluating Outcomes of Step-Cut Osteotomy for Pediatric Cubitus Deformities.","authors":"Adnan Anwer, Mohammad Jesan Khan, Naiyer Asif, Ariz Raza, Faisal Harun, Madhav Chowdhry","doi":"10.13107/jocr.2025.v15.i01.5196","DOIUrl":"10.13107/jocr.2025.v15.i01.5196","url":null,"abstract":"<p><strong>Introduction: </strong>Supracondylar fractures in children often result in malunion and subsequent cubitus varus or valgus deformity. While often considered cosmetic, these deformities can lead to pain, functional impairment, and other complications. Corrective osteotomy is a common treatment option, with step-cut osteotomy being a preferred method due to its effectiveness and relative simplicity. This study aims to evaluate the outcomes of step-cut osteotomy in correcting post-traumatic cubitus deformities.</p><p><strong>Materials and methods: </strong>A prospective cohort study was conducted on patients presenting with post-traumatic cubitus varus or valgus deformity. Pre-operative evaluation included clinical and radiological assessment of the deformity. Step-cut osteotomy was performed, followed by rigid fixation with a recon plate. Post-operative outcomes were assessed in terms of deformity correction, range of motion (ROM), and complications.</p><p><strong>Results: </strong>The study included 10 patients (8 male, 2 female) with a mean age of 9.6 years. The mean pre-operative carrying angle was 25.25° varus, corrected to 3.37° valgus postoperatively. Significant improvement in ROM and humerus-elbow-wrist angle was observed. While the lateral prominence index decreased, it was not statistically significant. Excellent or good results were achieved in 80% of patients. One patient experienced transient radial nerve palsy.</p><p><strong>Discussion: </strong>Step-cut osteotomy effectively corrected cubitus deformities with minimal complications. While it primarily addresses coronal plane deformity, satisfactory outcomes were achieved without correction of rotational deformity. Rigid fixation with a recon plate provided stability and allowed for early mobilization. The study's limitations include a small sample size and the inability to conduct adequate follow-up due to the COVID-19 pandemic.</p><p><strong>Conclusion: </strong>Step-cut osteotomy is a reliable and effective treatment option for post-traumatic cubitus varus and valgus deformities in children. It demonstrates good to excellent outcomes in terms of deformity correction, ROM, and functional improvement, with a low complication rate. Further studies with larger sample sizes and longer follow-up periods are warranted to strengthen these findings.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 1","pages":"266-272"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11723758/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142971266","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":"Diagnosing Mycobacterium Kansasii in Shoulder Periprosthetic Joint Infection: A Rare Case Report.","authors":"Dmitriy Peresada, Nirav Mungalpara, Abhi Deshpande, Michael Patetta, Benjamin Goldberg","doi":"10.13107/jocr.2025.v15.i01.5134","DOIUrl":"10.13107/jocr.2025.v15.i01.5134","url":null,"abstract":"<p><strong>Introduction: </strong>Periprosthetic joint infections (PJIs) of the shoulder complicate approximately 0.7% of primary and 15.4% of revision shoulder arthroplasties. Culture-negative PJIs constitute 5-42% of cases, with fungal and mycobacterial pathogens frequently implicated, often following broad-spectrum antibiotics administration prior to tissue sampling. Mycobacteria are isolated in 43% of culture-negative PJIs and associated with advanced age, chronic steroid therapy, immunosuppression, and retroviral infections. Improved diagnostic techniques have increased the isolation and reporting of non-tuberculous mycobacteria. Mycobacterium kansasii infections in native joints and bursae are documented, but only two cases of M. kansasii PJI, both in knee PJI, are reported. This report presents the first case of a shoulder PJI caused by M. kansasii.</p><p><strong>Case report: </strong>A 66-year-old female underwent right reverse total shoulder arthroplasty for glenohumeral osteoarthritis in November 2015. Post-operative recovery was initially uneventful, but 7 months later, she experienced persistent shoulder pain following a fall. Imaging confirmed proper component placement without loosening. In April 2017, extensive workup yielded negative results, including erythrocyte sedimentation rate and C-reactive protein. The patient returned in November 2018 with exacerbated pain, swelling, night sweats, and chills. Blood tests suggested no overt inflammation, but X-rays raised concerns of glenoid component loosening. January 2019 surgery revealed extensive synovitis and necrosis; a vancomycin and tobramycin-impregnated spacer was placed. Cultures identified M. kansasii, and the patient was treated with rifampin, azithromycin, and ethambutol for 12 months. Persistent pain led to multiple surgeries, with cultures confirming no infection. In January 2021, after consultation, long-term antimycobacterial therapy was initiated due to presumed recurrence. By June 2021, the patient reported no pain, and radiographs confirmed well-aligned prosthetic components.</p><p><strong>Conclusion: </strong>M. kansasii PJI, though rare, requires distinct diagnostic and treatment approaches compared to common pathogens. Diagnosis is often delayed due to the organism's slow growth and culture time, necessitating advanced techniques such as polymerase chain reaction and next-generation sequencing. Effective treatment involves extended antimycobacterial therapy and multiple surgeries. This case underscores the importance of monitoring for mycobacterial growth in suspected culture-negative PJIs and employing aggressive surgical and medical therapy to minimize complications.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 1","pages":"83-89"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11723734/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142971340","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}