Journal of Orthopaedic Case Reports最新文献

{"title":"Challenges in Diagnosing Diaphyseal Osteosarcoma - Importance of Strong Clinical Suspicion and Biopsy Technique: An Illustrative Case Report.","authors":"V Balaji, Mohammed Tavfiq, Subalakshmi Balasubramanian, J K Giriraj Harshavardhan, Sabare Naaharaaj","doi":"10.13107/jocr.2025.v15.i08.5934","DOIUrl":"10.13107/jocr.2025.v15.i08.5934","url":null,"abstract":"<p><strong>Introduction: </strong>Osteosarcoma is the most common primary malignant bone tumor in adolescents, typically affecting the metaphyseal region of long bones. Diaphyseal osteosarcoma is rare and often mimics benign conditions such as osteomyelitis, leading to diagnostic delays.</p><p><strong>Case report: </strong>A 17-year-old boy presented with progressive left thigh pain and swelling for 3 months. He had a trivial injury to left thigh 7 months back while playing kabaddi. Initial radiographs, computed tomography (CT), and magnetic resonance imaging showed a lytic intramedullary lesion with cortical thickening, suggestive of osteomyelitis. CT-guided biopsy also revealed features consistent with chronic osteomyelitis. Later debridement with open biopsy confirmed increased reactive osteoclastic giant cells, suggestive of chronic healed osteomyelitis. Despite empirical antibiotic treatment, symptoms worsened. A second open biopsy with intraoperative frozen section (FS) revealed features of high-grade osteosarcoma. Histopathological confirmation and immunohistochemistry with SATB2 established the diagnosis. The patient was treated with neoadjuvant chemotherapy followed by resection and femur reconstruction with a custom prosthesis.</p><p><strong>Discussion: </strong>This case illustrates the diagnostic pitfalls associated with diaphyseal osteosarcoma, especially in post-traumatic settings. It has also been observed in previous research studies that early overlapping clinical and radiological features with osteomyelitis often result in misdiagnosis. Needle biopsies, while minimally invasive, may yield non-representative samples, especially in heterogeneous tumors. Open biopsy targeting the lesion's transition zone, supported by intraoperative FS, enhances diagnostic accuracy and enables timely intervention.</p><p><strong>Conclusion: </strong>In atypical presentations of musculoskeletal pain and swelling unresponsive to conservative treatment, malignancy should be suspected. A multidisciplinary approach, early advanced imaging, and appropriately planned biopsies are critical for accurate diagnosis and effective management of osteosarcoma.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 8","pages":"184-190"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12328954/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144816938","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":"Chronic Syndesmotic Instability Associated with a Complex Lesion of the Posterior Inferior Tibiofibular Ligament: Review, Case Report, and Surgical Report.","authors":"Virginie Perez, Nermine Habib, Angela Seidel","doi":"10.13107/jocr.2025.v15.i08.5960","DOIUrl":"10.13107/jocr.2025.v15.i08.5960","url":null,"abstract":"<p><strong>Introduction: </strong>Syndesmotic injuries, particularly those involving the posterior inferior tibiofibular ligament (PITFL), are complex and often result in chronic pain and instability if not appropriately treated. The PITFL plays a crucial role in maintaining syndesmotic stability, especially in resisting rotational forces. This case report examines a PITFL injury involving two posterior fibular fragments, supporting the hypothesis that the superficial and deep components of the ligament function independently.</p><p><strong>Case report: </strong>A 41-year-old male presented after a bicycle accident with a complex ankle fracture involving a transverse medial malleolus fracture, a postero-medial tibial fragment, a fibular tip fracture, and two additional posterior fibular fragments. Despite initial fracture management, including closed reduction and open fixation, the patient developed chronic pain and instability due to malreduction. Computed tomography imaging revealed instability of the fibula within the fibular notch, indicating syndesmotic instability. The surgical procedure included fibular osteotomy, temporary fixation with K-wires, syndesmotic fixation with the TightRope® system, and PITFL repair using the InternalBrace™ ligament augmentation system. Intraoperative three-dimensional imaging confirmed successful reduction and stabilization.</p><p><strong>Conclusion: </strong>Fibular avulsion of the PITFL is rare. Failure to diagnose the lesion may lead to malreduction of the fibula within the incisura. The combination of osteotomy, TightRope® syndesmosis fixation, and InternalBrace™ PITFL repair provides a reliable option for managing complex PITFL injuries.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 8","pages":"256-259"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12328971/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144816940","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 Analysis of Dorsal Distraction Plating Versus External Fixation in the Management of Intra-Articular Distal Radius Fractures.","authors":"Ismail Pandor, Abhishek Sharma, Paresh Patil, Sushant Pandit, Prathamesh Karad, Alim Shaikh","doi":"10.13107/jocr.2025.v15.i08.5976","DOIUrl":"10.13107/jocr.2025.v15.i08.5976","url":null,"abstract":"<p><strong>Introduction: </strong>Fractures located in close proximity to the lower end of the radius bone, which make up around 16% of fractures requiring emergency treatment require careful treatment to regain mobility in the wrist joint and the fingers. Although classic external fixation (ExFix) methods are widely used, newer procedures such as dorsal distraction plating are showing potential . This study investigates the concepts, debates, and results of several methods so that to determine the most effective fracture treatment.</p><p><strong>Materials and methods: </strong>The experiment will recruit individuals with intricate fractures affecting the joint across the distal region of the radius. The patients will be randomly randomized to receive either dorsal distraction plating or ExFix. Pre-operative, post-operative, and follow-up assessments will involve clinical and radiographic examinations. Functional outcomes will be evaluated using standardized scoring systems . A comparative statistical analysis will be performed to assess the outcomes obtained from both groups.</p><p><strong>Results: </strong>The average ages across the bridge plate and ExFix sections were 40 and 43 years, respectively. The cohort of patients who had bridge plating exhibited a greater prevalence of male individuals (P = 0.011). The ExFix group had elevated infection rates, which can be ascribed to the occurrence of pin tract infections. Both the groups did not show any instances of nerve palsy. Patients who received dorsal distraction plating expressed higher levels of satisfaction with their post-operative results, both in terms of functionality and appearance .</p><p><strong>Discussion: </strong>Patients treated with dorsal distraction reported fewer issues. Although a few difficulties were observed, the most of these patients expressed high levels of satisfaction with the results of their surgical procedures . The findings suggest that dorsal distraction may offer a more favorable balance between functional recovery and patient satisfaction, highlighting a potential advantage over ExFix. In the long run, however, the functional outcomes of both the techniques were found to be similar.</p><p><strong>Conclusion: </strong>Dorsal bridge plating is a viable substitute for ExFix in treating distal radius fractures. The use of dorsal bridge plating demonstrated greater performance in daily activities, despite the fact that the functional and radiological findings at 6 months were found to be almost indistinguishable in both groups .</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 8","pages":"300-305"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12328975/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144816942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Case Report of a Rare Entity - Lateral End of Clavicle Chondromyxoid Fibroma which was Mistaken as Giant Cell Tumor and Aneurysmal Cyst.","authors":"N Sharon Rose, Sri Ravindranath Vutukuru, Y Ranjith Kumar, Mettu Anil Kumar, Umesh Sunkari, J H Vidyasagar","doi":"10.13107/jocr.2025.v15.i08.5900","DOIUrl":"10.13107/jocr.2025.v15.i08.5900","url":null,"abstract":"<p><strong>Introduction: </strong>The clavicle is an uncommon site for tumors, as it is a flat bone and rarely affected by neoplasms. Most clavicular tumors are malignant, with metastases and Ewing's sarcoma being the most common. Overall, clavicular neoplasms account for <1% of all bone tumors, and chondromyxoid fibroma (CMF) is particularly rare, comprising <1% of cases. This tumor typically arises in the metaphysis of the proximal tibia.</p><p><strong>Case report: </strong>A young male patient comes with lateral end clavicle swelling, which on radiologically was diagnosed giant cell tumor. Later on, needle biopsy was thought to be an aneurysmal bone cyst (ABC). Finally, it turned out to be CMF on biopsy.</p><p><strong>Conclusion: </strong>This case report presents a rare instance in which CMF was initially misdiagnosed as a giant cell tumor based on radiological findings and later as an ABC after histopathological examination. The definitive diagnosis of CMF was only confirmed following excisional biopsy.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 8","pages":"102-106"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12328957/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144816910","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":"Randomized Control Trial Comparing Effects of Tourniquets on Neurology and Functional Outcomes after Total Knee Arthoplasty.","authors":"Gur-Aziz Singh Sidhu, Saphalya Pattnaik, Mothana Gawad, Rafia Ghani, Harjot Kaur, Neil Ashwood","doi":"10.13107/jocr.2025.v15.i08.5974","DOIUrl":"10.13107/jocr.2025.v15.i08.5974","url":null,"abstract":"<p><strong>Introduction: </strong>Total knee arthroplasty (TKA) often uses a tourniquet to enhance surgical visualization and reduce intraoperative blood loss. Despite its benefits, tourniquet use is associated with several complications such as skin blistering, nerve palsy, and deep vein thrombosis. The literature reveals a divided opinion on whether TKA should be performed with or without a tourniquet, with conflicting results on post-operative pain, blood loss, and functional outcomes..</p><p><strong>Materials and methods: </strong>This study included patients aged 65 to 90 years undergoing elective unilateral TKA for osteoarthritis. Exclusion criteria included patients with a Body mass index ≥35, rheumatoid arthritis, peripheral vascular disease, diabetes, prior knee surgery, and on anticoagulation medication. The study focused on comparing the neurology through nerve conduction studies and functional outcomes of TKA performed with and without a tourniquet. Some key metrics included intraoperative blood loss, surgical duration, post-operative pain, analgesic use, and range of motion (ROM).</p><p><strong>Results: </strong>The study recruited 55 patients aged ranging from 65 to 90 years who were randomized into two groups.22 patients were excluded, and the final analysis involved 23 patients. Tourniquet use resulted in lower blood loss (140 mL vs. 215 mL) and shorter operative times (87 min vs. 95 min) compared to the non-tourniquet group. However, the tourniquet group had higher incidences of nerve palsy in the immediate post-operative period as compared to the other group. Both the groups showed significant improvements in post-operative ROM, but the tourniquet group had higher post-operative pain and analgesic requirements, and this was statistically significant.</p><p><strong>Conclusion: </strong>Tourniquet use in TKA reduces intraoperative blood loss and operative time but is associated with a higher risk of nerve-related complications and increased post-operative pain. The findings suggest that avoiding tourniquet use may lead to better overall clinical outcomes and early post-operative ROM.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 8","pages":"294-299"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12328953/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144816874","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":"Elbow Interpositional Arthroplasty using an Achilles Tendon Allograft: A Case Report.","authors":"Matthew Glazier, Morgan Turnow, Hunter Pharis, Taylor Manes, Hayden Schuette, Stephen Wiseman","doi":"10.13107/jocr.2025.v15.i08.5938","DOIUrl":"10.13107/jocr.2025.v15.i08.5938","url":null,"abstract":"<p><strong>Introduction: </strong>The treatment of post-traumatic elbow arthritis poses a significant challenge for orthopedic surgeons, especially in young active patients. Total elbow arthroplasty is often the recommended treatment option in older patients; however, interpositional arthroplasty remains a viable option in high-demand patients.</p><p><strong>Case report: </strong>We report a case of a 50-year-old male who presented after the development of post-traumatic arthritis of the elbow after multiple prior surgeries. He was treated with an interpositional arthroplasty using an Achilles tendon graft and allowed immediate range of motion as tolerated in a hinged elbow brace without the use of any form of distraction external fixation. At his final follow-up, he has significantly improved pain, range of motion, and patient-reported Visual Analog Scale , American shoulder and elbow surgeons, mayo elbow performance score, and disabilities of the arm, shoulder and hand scores.</p><p><strong>Conclusion: </strong>This case report demonstrated that interpositional arthroplasty is a viable option for managing post-traumatic elbow osteoarthritis in young patients and with good ligamentous stability, immediate protected range of motion, as tolerated, can lead to excellent outcomes.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 8","pages":"196-200"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12328927/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144816916","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":"Triple Traumatic Fracture-Dislocation: A Rare Case of Simultaneous Ipsilateral Hip, Knee, and Ankle Fracture-Dislocation with a Review of the Literature.","authors":"Laxman Choudhary, Bharat Kumar Soni, Aakarsh Aggarwal, Kuldeep Rathor, Sumit Banerjee, Abhay Elhence","doi":"10.13107/jocr.2025.v15.i08.5866","DOIUrl":"10.13107/jocr.2025.v15.i08.5866","url":null,"abstract":"<p><strong>Introduction: </strong>Co-occurrence of ipsilateral hip, knee, and ankle fracture-dislocation is a rare condition demanding heightened urgency, constituting an emergency warranting immediate attention and utmost care. Delineating the management of such injury is required so that satisfactory functional outcomes can be achieved in this uncommon injury.</p><p><strong>Case report: </strong>A 41-year-old male was alleged to have sustained a road traffic accident, following which he presented to the emergency department of a tertiary care center with pain over the left hip, knee, and ankle joints, and deformity of the same limb. He was evaluated and diagnosed with ipsilateral hip fracture-dislocation, knee fracture-dislocation, and bimalleolar ankle fracture with ankle subluxation. He underwent open reduction internal fixation (ORIF) with raft plate (7H) for the proximal tibia fracture and two Herbert screws for the tibial spine fracture for fixing the knee fracture-dislocation. ORIF with 2 CC screw for medial malleolus and ORIF with 1 CC screw for lateral malleolus was done to fix ankle fracture subluxation. No surgical intervention was required for hip fracture-dislocation.</p><p><strong>Conclusion: </strong>Simultaneous ipsilateral hip, knee, and ankle fracture-dislocation is a rare condition that should be approached as a limb-threatening orthopedic emergency. We report this case for its rarity and to document that good results can be achieved with early appropriate care.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 8","pages":"11-17"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12328988/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144816964","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":"Failure of Metal-on-Metal Total Hip Arthroplasty: The First Reported Case from the Caribbean and the Need for a National Joint Registry.","authors":"Marlon M Mencia, Pedro Pablo Hernandez Cruz","doi":"10.13107/jocr.2025.v15.i08.5878","DOIUrl":"10.13107/jocr.2025.v15.i08.5878","url":null,"abstract":"<p><strong>Introduction: </strong>The predicted advantages of better survivorship and function from metal-on-metal (MoM) total hip arthroplasty (THA) systems introduced in the early 2000s did not materialise. Instead, national registry data indicated high failure rates, and these devices were quickly withdrawn from the market. With over 1 million MoM articulations implanted worldwide, there is a need for close follow-up and surveillance of the at-risk population.</p><p><strong>Case report: </strong>A 54-year-old woman presented with a painful right MoM hip arthroplasty. Serial radiographs demonstrated progressive migration of the acetabular shell with extensive osteolysis. After medical clearance, the patient underwent a successful isolated acetabular revision. The bone defects were filled with bone substitute, and the acetabulum was reconstructed using a metal cage and a cemented all-polyethylene cup.</p><p><strong>Conclusion: </strong>MoM THA is associated with a high failure rate and the need for early revision. An unverified number of these implants were used in Trinidad in 2009, leaving patients at risk for premature failure. In the Caribbean, the medical devices industry is largely under-regulated, exposing the patient to unnecessary risks. The formation of a national joint registry administered through the Caribbean Association of Orthopedic Surgeons could provide outcome data, identify early implant failures, and improve patient safety.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 8","pages":"46-51"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12328933/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144816919","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":"Haemophilus influenzae Acute Prosthetic Joint Infection: A Rare Case Report on Time-Critical, Pathogen-Specific Management.","authors":"Shreya Chaudhuri, Rahul Kakran, Vipin Tyagi","doi":"10.13107/jocr.2025.v15.i08.5870","DOIUrl":"10.13107/jocr.2025.v15.i08.5870","url":null,"abstract":"<p><strong>Introduction: </strong>Prosthetic joint infections (PJIs) are a serious complication of arthroplasty, often necessitating prolonged therapy and revision surgeries. Haemophilus influenzae is an uncommon cause of PJI, especially in immunocompromised individuals and individuals with co-morbidities. Its fastidious nature frequently leads to negative cultures, delaying diagnosis and targeted therapy.</p><p><strong>Case report: </strong>We report the case of a 52-year-old male with rheumatoid arthritis on immunosuppressive therapy, who presented with acute right hip pain, swelling, and purulent wound discharge 3 months after revision total hip arthroplasty. Initial workup revealed elevated inflammatory markers and signs of joint infection (JI). Conventional microbiological methods including Gram stain, acid-fast bacilli testing, and enrichment cultures were inconclusive. However, syndromic multiplex polymerase chain reaction (PCR) using the BioFire® JI panel detected H. influenzae within 2 h of intraoperative sample collection. The patient underwent debridement, targeted antibiotic therapy, and implant retention (DAIR). Empirical therapy with meropenem and vancomycin was promptly de-escalated to intravenous ceftriaxone, based on PCR results. Clinical recovery was marked by rapid decline in C-reactive protein, resolution of symptoms, and a successful switch to oral therapy. At 6-week and 16-week follow-up, the patient was asymptomatic, with normal inflammatory markers and radiographs, and a functioning retained implant.</p><p><strong>Conclusion: </strong>This case underscores the clinical value of rapid syndromic testing in detecting rare, fastidious pathogens like H. influenzae in PJIs. The early identification facilitated timely DAIR, targeted antibiotic therapy, reduced hospital stays, and preserved the implant. The approach highlights the role of molecular diagnostics in enhancing antimicrobial stewardship and improving clinical outcomes in complex orthopedic infections.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 8","pages":"24-29"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12328987/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144816924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Prospective Randomized Study Comparing the Efficacy of Electrotherapy to Ultrasound - Guided Intra-Articular Steroid Injections for Frozen Shoulder.","authors":"Saravana Kumar, Vejaya Kumar, Srinivasan Balasubramanian, Saravanan Kasirajan","doi":"10.13107/jocr.2025.v15.i08.5986","DOIUrl":"10.13107/jocr.2025.v15.i08.5986","url":null,"abstract":"<p><strong>Background: </strong>Frozen shoulder (adhesive capsulitis) is a disabling condition marked by pain and restricted range of motion (ROM). This study compares the effectiveness of electrotherapy (ET) and ultrasound-guided intra-articular steroid injections (UG-IASI), two common non-operative treatments.</p><p><strong>Materials and methods: </strong>In this prospective, randomized trial, 60 patients with unilateral Frozen shoulder were assigned to either ET (n = 30) or UG-IASI (n = 30). Outcomes were assessed at baseline, 1, 3, and 6 months, and 1 year using the shoulder pain and disability index (SPADI) and ROM measurements. Statistical analyses included mixed-effects models and subgroup analysis for diabetes.</p><p><strong>Results: </strong>UG-IASI resulted in significantly greater SPADI and ROM improvements than ET at 1, 3, and 6 months (P < 0.05). By 1 year, the difference was no longer significant. UG-IASI showed notable gains in abduction and flexion. Diabetic patients experienced reduced improvements across both groups.</p><p><strong>Conclusion: </strong>UG-IASI provides superior early and mid-term outcomes in pain relief and shoulder function compared to ET. While long-term differences narrow, early intervention with UG-IASI supports faster recovery. A tailored approach, considering comorbidities and patient needs, is recommended for optimal care.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 8","pages":"332-339"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12328950/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144816926","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}