Journal of Orthopaedic Case Reports最新文献

{"title":"Fibrous Dysplasia in Humerus Shaft - Fixation or Curettage?: A Case Report.","authors":"Aman Rai, J K Giriraj Harshvardhan, Sundar Suryakumar, C Sitsabesan, M Mohd Tavfiq","doi":"10.13107/jocr.2025.v15.i05.5552","DOIUrl":"https://doi.org/10.13107/jocr.2025.v15.i05.5552","url":null,"abstract":"<p><strong>Introduction: </strong>Fibrous dysplasia is a benign skeletal condition characterized by abnormal osteoblastic differentiation and maturation, typically affecting the lower extremity and craniofacial skeleton. It usually manifests in the first three decades of life, with symptoms starting in early childhood. Radiologically, it appears as an expansile, lytic, intramedullary, diaphyseal, or metaphyseal lesion. Treatment options include nonsurgical surveillance, pharmacotherapy, and surgery. Bisphosphonates can manage painless lesions, whereas surgery is necessary for pathological fractures. Alternative treatments include curettage, bone grafting, and internal fixation.</p><p><strong>Case report: </strong>A 24-year-old woman experienced pain in her right arm for 3 years, which had worsened over the past 3 months and was accompanied by swelling for 2 months. The pain was insidious, gradually progressive, and diffuse over the diaphyseal region of the humerus. Examination revealed bony swelling and thickening, restricted shoulder movement and no distal neurovascular deficit.Radiologically, there was an expansile lytic lesion involving the middle and distal third of the diaphysis of the right humerus, suggesting pathological fractures. A magnetic resonance imaging scan revealed an expansile intramedullary lesion involving almost the entire shaft of the right humerus, sparing the proximal metaphyseal region. Histopathological examination revealed hemorrhagic giant cells with fibroblastic proliferation, with no signs of malignancy. Intramedullary fixation was performed with an intramedullary interlocking nail. She began gentle shoulder range-of-motion exercises and pendulum exercises. The patient experienced significant pain relief with good functional outcome and signs of fracture healing.</p><p><strong>Conclusion: </strong>Long bones with fibrous dysplasia that manifest as pathological fractures may be painful and have limited mobility. The fracture can heal, pain can be reduced, and the functional range of motion can be restored by stabilizing the lesion with an intramedullary implant without curettage or bone grafting.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 5","pages":"50-55"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12064243/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143997691","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":"Patellar Osteoid Osteoma: A Rare Cause for Anterior Knee Pain.","authors":"Sushruth Jagadish, Amaresh Cadapa Prahallad, Harshavardhan Bhaktharahalli Ramachandra, Nanjunda Kumar","doi":"10.13107/jocr.2025.v15.i05.5542","DOIUrl":"https://doi.org/10.13107/jocr.2025.v15.i05.5542","url":null,"abstract":"<p><strong>Introduction: </strong>Osteoid osteoma is a benign osteoblastic lesion occurring in the diaphysis of the long bones most commonly. Patellar osteoid osteoma is very rare and most commonly associated with anterior knee pain.</p><p><strong>Case report: </strong>A 21-year-old male presenting with anterior knee pain was diagnosed to have patellar osteoid osteoma after 4 years of onset of symptoms and was treated with radiofrequency ablation. One year following the ablation patient remains pain-free and has a complete range of movements.</p><p><strong>Conclusion: </strong>Atypical location of the tumor makes it difficult to diagnose resulting in delayed management. Hence, it is important to have patellar osteoid osteoma as one of the differential diagnosis in patients having chronic anterior knee pain. Radiofrequency ablation is a novel and minimally invasive procedure for the treatment of Patellar Osteoid Osteoma which can help in resolution of anterior knee pain.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 5","pages":"25-28"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12064223/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143997961","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":"Rise of Revision Arthroplasties in Indian Subcontinent: An Inadvertent Future.","authors":"Kunal Aneja, Supreet Bajwa, Ashok Shyam","doi":"10.13107/jocr.2025.v15.i05.5532","DOIUrl":"https://doi.org/10.13107/jocr.2025.v15.i05.5532","url":null,"abstract":"","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 5","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12064231/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143976549","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":"Understanding the Levels of Evidence in Medical Research.","authors":"Arvind Vatkar, Sachin Kale, Ashok Shyam, Sushant Srivastava","doi":"10.13107/jocr.2025.v15.i05.5534","DOIUrl":"https://doi.org/10.13107/jocr.2025.v15.i05.5534","url":null,"abstract":"<p><p>The advancement of evidence-based medicine (EBM) depends on the evidence hierarchy, a framework for classifying research approaches according to their dependability and quality. It dates back to the middle of the 20th century and classifies techniques such as expert opinions, case reports, randomized controlled trials, and systematic reviews. However, problems such as prejudice and moral constraints still exist. Evidence paradigms are being redefined by emerging technologies such as artificial intelligence, big data, and real-world data. This calls for dynamic hierarchies that include many forms of evidence. High-quality data are essential for developing flexible frameworks for contemporary medicine and influencing clinical guidelines, public health regulations, and educational initiatives.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 5","pages":"6-9"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12064251/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143976818","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":"Burkholderia pseudomallei-induced Oligoarticular Septic Arthritis Masquerading as Tuberculosis in a Non-Diabetic Host from Northern Kerala.","authors":"Ramesh Govindharaaju, Raju Karuppal, Khayas Omer Kunheen, Anand Leo George, A Salmanul Faris","doi":"10.13107/jocr.2025.v15.i05.5560","DOIUrl":"https://doi.org/10.13107/jocr.2025.v15.i05.5560","url":null,"abstract":"<p><strong>Introduction: </strong>Burkholderia pseudomallei, the causative agent of melioidosis, is endemic in tropical and subtropical regions, primarily in Southeast Asia and northern Australia. Cases of septic arthritis caused by B. pseudomallei in India have rarely been reported and have been described mostly in diabetic patients. This case report outlines a case of oligoarticular septic arthritis in a non-diabetic patient with a previous history of extrapulmonary tuberculosis (TB).</p><p><strong>Case report: </strong>A 62-year-old non-diabetic male receiving anti-tubercular therapy (ATT) for tubercular lymphadenitis presented with complaints of painful swelling of his left knee and right shoulder. Before consulting with us, he had undergone an arthrotomy and biopsy of his left knee at a different center. The biopsy was suggestive of granulomatous inflammation with negative cultures and acid-fast bacillus, for which he was advised to continue ATT for an extended duration. ATT did not improve his symptoms, and the patient developed a gradually progressing painful swelling of his right shoulder. At this point, he presented to us. Fresh cultures revealed B. pseudomallei as the causative organism. A strict regimen of intravenous ceftazidime followed by oral cotrimoxazole resulted in gradual recovery.</p><p><strong>Conclusion: </strong>Cases of B. pseudomallei-induced infective arthritis and systemic melioidosis are now being identified in India, probably as a result of increased cross-country travel. This case report describes oligoarticular septic arthritis in a non-diabetic patient, which is unique among similar cases in the literature. A previous history of TB and negative routine cultures confounded the diagnosis.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 5","pages":"70-74"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12064257/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144016293","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":"Case of Enchondroma of Left 4th Metacarpal of Hand Treated with Excision and Bone Grafting with Left 2nd Metatarsal of Foot: A Rare Case Report.","authors":"Swaroop Solunke, Anup Bansode, Aishwary Verma, Selvi Khajanchi, Setu Kaneria","doi":"10.13107/jocr.2025.v15.i05.5610","DOIUrl":"https://doi.org/10.13107/jocr.2025.v15.i05.5610","url":null,"abstract":"<p><strong>Introduction: </strong>Enchondroma of the hand is a common lesion with a recurrence rate of up to 13.3% after curettage and bone grafting. When hand enchondroma is suspected, less common conditions, such as multiple enchondromatosis syndromes and benign and malignant lesions, should be ruled out. Pathologic fractures often occur. Post-operative complications are typically joint stiffness and soft-tissue-related deformities, whereas recurrence and malignant degeneration of solitary lesions are much less common. Most patients return to full function after surgery.</p><p><strong>Case report: </strong>We present a case of enchondroma of the fourth metacarpal in a 38-year-old female who has a history of a mishap that occurred 3 months ago. Radiographic evaluation was done by X-ray and magnetic resonance imaging which revealed a well-marginated lytic lesion in the head, neck, and distal phalanx of the left 4th finger and significant cortical destruction, completely replacing the bone in the affected region. There was no involvement of the metacarpophalangeal joint. The patient was planned for excision of the 4th metacarpal and bone grafting, plating and K-wire fixation with the 2nd metatarsal bone graft. Post-operatively below elbow slab was given for the patient to promote wound healing and fracture healing for 4 weeks. After 2 weeks of surgery gradual wrist movements were started. Follow-up radiographs were taken every 4 weeks to check for union of bone. Upon radiographic union, finger movement was gradually started as tolerated by the patient. After 8 weeks of surgery radiograph showed a union of bone and K-wires were removed under local anesthesia and full finger movement was started. The patient achieved full finger movement in 12 weeks post-operatively.</p><p><strong>Conclusion: </strong>Enchondroma of the hand has a non-specific clinical presentation and a variable radiographic appearance. A patient-specific differential diagnosis should be established because various benign and malignant processes can mimic enchondroma radiographically. Nevertheless, controversy surrounds the roles of post-curettage surgical adjuncts, immediate versus delayed grafting and fixation, and void management. Surgical management, involving lesion excision and autograft reconstruction, demonstrated excellent results, enabling complete healing and restoration of function within 20 weeks post-operatively. This approach highlights the efficacy of precise surgical techniques combined with structured post-operative rehabilitation in achieving optimal patient outcomes.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 5","pages":"198-203"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12064239/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144004604","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":"Enhancing Orthopedic Residents Learning: The Role of Briefing, Reverse Operative Teaching, and Debriefing.","authors":"Ramy Samargandi","doi":"10.13107/jocr.2025.v15.i05","DOIUrl":"https://doi.org/10.13107/jocr.2025.v15.i05","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of this study is to evaluate the impact of the briefing, reversed operative teaching, and debriefing methods, aiming to enhance the learning process of orthopedic residents in the operating room.</p><p><strong>Materials and methods: </strong>This was a quantitative, cross-sectional study conducted over six months among orthopedic residents. A novel pedagogical model incorporating briefing, reverse operative teaching, and debriefing was implemented and compared to traditional methods. A structured validated questionnaire was used to evaluate the residents' perceptions and satisfaction. Data were analyzed using descriptive statistics.</p><p><strong>Results: </strong>A total of 16 orthopedic residents participated in the study, including eight junior and eight senior residents. The majority reported high levels of satisfaction with the new teaching approach. Key benefits included improved engagement, enhanced knowledge retention, and better mastery of surgical procedures. Residents also noted clearer guidance from senior surgeons, increased confidence in asking questions, and more efficient preparation using targeted educational resources. Most participants expressed a desire to adopt this method in their future teaching roles.</p><p><strong>Conclusion: </strong>The novel teaching method showed promising results and could be beneficial for the training of orthopedic residents.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 5","pages":"218-225"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12064246/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144000712","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 Combination Strategy of the Drainage and Resection under the Microendoscope for Giant Discal Cyst: A Case Report.","authors":"Takuhei Kozaki, Takahiro Kozaki, Hiroshi Yamada","doi":"10.13107/jocr.2025.v15.i05.5582","DOIUrl":"https://doi.org/10.13107/jocr.2025.v15.i05.5582","url":null,"abstract":"<p><strong>Introduction: </strong>Discal cysts have been reported as intraspinal extradural cysts connected with corresponding intervertebral discs. The resection of the discal cyst has illustrated the good result. However, we report a much larger discal cyst, which was seemed to be difficult to resect all of them under the microendoscope safety.</p><p><strong>Case report: </strong>A 21-year-old man had experienced pain in the right lower limb for at least a month and was diagnosed with radiculopathy of the right S1 nerve root. Magnetic resonance image showed that mild disc degeneration and cyst at L5/S1, which was measured 12.0 mm on the sagittal view, accounted for 71.1% of the sagittal diameter of the spinal canal. He underwent hemi-flavectomy and the resection of the cyst under the microendoscope. During surgery, we found that there was not enough space in the epidural to remove the cyst safety without the laminectomy. The right S1 nerve root was strongly pushed to the dorsal side, adhered, and stretched by the cyst. First, we have tried to drain the liquid context of the cyst and decrease the volume to make the enough epidural space to perform the surgical procedure safety. Second, we resected the wall, which procedure made the nerve root loosen.</p><p><strong>Conclusion: </strong>The combination of the drainage and resection under the microendoscope has ability to secure the enough working space, prevent the nerve root injury, and minimize the surgical invasion. This strategy can expand the surgical indication for the larger cystic lesion, which have been performed by the open surgery so far.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 5","pages":"128-131"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12064224/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143970555","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 Rare Case Report Of Incidental Distal Ulna Giant Cell Tumour Presented As Distal Ulna Fracture.","authors":"Rohit Karthik, Vijay Narasimman Reddy, Subramanya Gandhi, Rajlaxmi Reddy","doi":"10.13107/jocr.2025.v15.i05.5606","DOIUrl":"https://doi.org/10.13107/jocr.2025.v15.i05.5606","url":null,"abstract":"<p><strong>Introduction: </strong>Giant cell tumour of ulna is a rare and benign neoplasm but is locally invasive tumour. Distal ulna giant cell tumors have a reported incidence of 0.45 to 0.6%.</p><p><strong>Case report: </strong>43 years old female came with alleged History of slip and fall at her residence sustaining injury to right wrist and suspected to be a giant cell tumor. The giant cell tumour was treated with en bloc resection and curettage (Darrach's procedure). Patient was followed up for 6 months during which she regained full range of motion.</p><p><strong>Conclusion: </strong>Giant cell tumor can masquerade as pathological fracture with En bloc Resection dramatically reducing the risk of recurrence.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 5","pages":"184-189"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12064234/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144005601","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":"Synovial Hemangioma of Knee in 4-Year-Old Girl Child - A Case Report.","authors":"Gajanan Kishor Deshmukh, Uday Prabhakar Phute, Dipak Bhimrao Bhange","doi":"10.13107/jocr.2025.v15.i05.5596","DOIUrl":"https://doi.org/10.13107/jocr.2025.v15.i05.5596","url":null,"abstract":"<p><strong>Introduction: </strong>Synovial hemangioma of the knee is rare in children. It was first described in history by Bouchut in 1856 [1]. Hemangioma in children is difficult to diagnose, and chances of missing diagnosis are frequent. It is essential to treat hemangioma early, as delayed treatment can result in joint destruction and arthrosis.</p><p><strong>Case report: </strong>We discuss the case report of a 4-year-old girl with non-traumatic recurrent knee swelling since 6 months previous episode 7 days back. The patient was previously treated with aspiration and a short course of antibiotics, magnetic resonance imaging (MRI) s/o synovitis; we opted for open excision of mass. On follow-up, the patient was completely disease-free.</p><p><strong>Conclusion: </strong>Synovial hemangioma is difficult to diagnose in children, a high index of suspicion is required, MRI is an investigation of choice, and open or arthroscopic excision is the treatment of choice.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 5","pages":"161-164"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12064269/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144063602","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}