Journal of Orthopaedic Case Reports最新文献

{"title":"Measured Flap Planning for Adult Complex Syndactyly Release: A Technical Case Report.","authors":"Jeff Walter Rajadurai Or, J Jebin Levi, M Sathesh Kumar, K Purushothaman, N Kanchan, S M M Moulvi","doi":"10.13107/jocr.2026.v16.i10.8276","DOIUrl":"10.13107/jocr.2026.v16.i10.8276","url":null,"abstract":"<p><strong>Introduction: </strong>Adult untreated complex syndactyly is a rare clinical presentation and may pose a unique set of reconstructive challenges due to long-standing tissue adaptation. Various flap designs for syndactyly release are described, but pre-operative planning of the flaps is often based on visual estimation and surgeon experience. We report a systematic measurement-based flap planning technique (MFPT) in the reconstruction of complex syndactyly in an adult patient.</p><p><strong>Case report: </strong>A 23-year-old male presented with an untreated complex congenital syndactyly of the middle and ring fingers with functional limitation and esthetic concerns. The clinical examination showed fusion to the fingertips with confluent nail plates with no evident involvement of the nail folds. Radiographs showed soft-tissue syndactyly with bony fusion of the distal ends of the distal phalanges. Pre-operative planning included identification of the anatomical landmarks, determination of a central dorsal axis, evaluation of the digital width, marking of the corresponding zig-zag flaps, planning of the web commissure and verification of the flap symmetry prior to incision. These markings were used to guide surgical dissection and soft-tissue reconstruction, sparing the digital neurovascular bundles and nail beds. Post-operative radiographs demonstrated separation of the previously fused distal phalanges.</p><p><strong>Discussion: </strong>Current techniques for syndactyly release are primarily based on flap design and web space reconstruction, with pre-incision planning possibly remaining subjective to surgeon judgment. MFPT provides a systematic sequence in the translation of anatomical landmarks, digital width evaluation, flap correspondence, web- apex positioning and symmetry verification to the pre-operative marking process. In this situation, the technique was feasible as a planning aid to standard syndactyly reconstruction. Its reproducibility and potential advantages over conventional planning need to be evaluated in larger prospective studies with pre-defined geometric and functional outcome measures.</p><p><strong>Conclusion: </strong>MFPT is a structured, measurement-based protocol for pre-operative planning of flaps in adult complex syndactyly. This allowed for systematic flap marking and subsequent reconstruction. Future studies should assess its reproducibility, clinical utility, and potential advantages over traditional experience-based flap planning.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"16 10","pages":"308-313"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13646611/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149137138","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":"All Arthroscopic Decompression and Bone Grafting of Cyst in the Talus.","authors":"Hari Krishna Yadoji, Ashok Raju Gottemukkala, Vasudeva Juvvadi, Guru Krishna Yadoji","doi":"10.13107/jocr.2026.v16.i10.8252","DOIUrl":"10.13107/jocr.2026.v16.i10.8252","url":null,"abstract":"<p><strong>Introduction: </strong>A talar cyst is a fluid-filled sac in the talus bone, often caused by chronic stress fractures or traumatic injuries. A talar cyst if left untreated can result in chondromalacia of talus cartilage and ultimately arthritis. A timely intervention of cyst can have very good prognosis. An open cyst decompression and bone grafting is a standard procedure followed, but it is more invasive and sometimes involves medial malleolus osteotomy. If the same is done by arthroscopy, the morbidity of open procedure can be avoided.</p><p><strong>Case report: </strong>A 34-year-old male complaining of pain in the ankle while walking for 3 months. There is no history of trauma. Patient has no rest pain. X-ray ankle anteroposterior and lateral shows a cystic lesion in the talus. An magnetic resonance imaging (MRI) was done which shows a cyst around 35 × 18 mm × 14 mm in the anteromedial talus. We preferred MRI over computed tomography scan as MRI gives the status of cartilage of tibiotalar joint along with cyst location and type of cyst also.</p><p><strong>Conclusion: </strong>Arthroscopic cyst decompression is a good alternative to open decompression with less morbidity and speedy recovery. Patient selection is the key factor. This procedure is indicated for talar bone cysts associated with small osteochondral lesions or intact articular surface.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"16 10","pages":"243-246"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13646573/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149136909","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":"Dual Mobility Total Hip Arthroplasty for Recurrent Dislocation After Femoral Neck Fracture in an Elderly Patient: A Case Report.","authors":"Tetsuya Sakamoto, Teruaki Izaki","doi":"10.13107/jocr.2026.v16.i10.8266","DOIUrl":"10.13107/jocr.2026.v16.i10.8266","url":null,"abstract":"<p><strong>Introduction: </strong>Recurrent dislocation after bipolar hemiarthroplasty for femoral neck fracture is a challenging complication, particularly in elderly patients with risk factors for instability such as cognitive impairment, soft-tissue insufficiency, and muscle weakness. Dual mobility total hip arthroplasty has been increasingly used to improve hip stability in patients at high risk of dislocation.</p><p><strong>Case report: </strong>An 83-year-old woman with dementia sustained a Garden type III femoral neck fracture and underwent bipolar hemiarthroplasty through a posterior approach. Three months after the initial surgery, she developed posterior dislocation of the hip. Thereafter, posterior dislocation occurred almost daily despite repeated closed reductions. She had no Parkinson's disease or paralysis. Due to severe recurrent instability, conversion total hip arthroplasty was performed through a posterior approach using a dual mobility acetabular component. The femoral stem was well fixed and was retained. A Zimmer Biomet G7 dual mobility cup was implanted with an inclination angle of 49° and an anteversion angle of 19°. At the 2-year follow-up, no redislocation had occurred. The patient was able to walk with a cane, and the Harris Hip Score was 80 points. Written informed consent for publication was obtained from the patient and her family.</p><p><strong>Conclusion: </strong>Dual mobility total hip arthroplasty may be an effective stem-retaining salvage option for severe recurrent posterior dislocation after bipolar hemiarthroplasty for femoral neck fracture in elderly patients with cognitive impairment. The clinical significance of this case is that durable stability was achieved without femoral stem revision in a patient with almost daily posterior dislocation, supporting dual mobility acetabular reconstruction as a practical option when the femoral component is well fixed and instability is multifactorial.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"16 10","pages":"281-285"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13646561/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149137077","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":"Open Posterolateral Elbow Dislocation in an Adult after Low-Energy Trauma: A Case Report Highlighting Diagnostic and Operative Considerations.","authors":"John Wahhab, Sebastian M Scofield, Thomas Turinske","doi":"10.13107/jocr.2026.v16.i10.8214","DOIUrl":"10.13107/jocr.2026.v16.i10.8214","url":null,"abstract":"<p><strong>Introduction: </strong>Open elbow dislocations are rare injuries in adults, accounting for <2% of cases, and may occur even after low-energy mechanisms. Their presentation can be subtle, particularly when periarticular wounds appear benign, leading to delayed recognition of joint violation. Early identification of intra-articular air and associated soft-tissue injury is essential to guide timely operative management. This case highlights the diagnostic challenges and surgical considerations associated with an uncommon open posterolateral elbow dislocation following a low-energy fall.</p><p><strong>Case report: </strong>A middle-aged man presented after slipping and landing on an outstretched right arm, resulting in a posterolateral elbow dislocation with an associated medial elbow laceration. The joint was reduced in the emergency department, and the wound was irrigated and repaired. Subsequent computed tomography (CT) imaging revealed intra-articular air concerning for an open dislocation. The patient underwent operative irrigation and debridement, during which complete avulsion of the flexor pronator mass from the medial epicondyle was identified and repaired. The elbow remained stable intraoperatively and was immobilized in a long arm splint.</p><p><strong>Result: </strong>The patient received 24 h of intravenous antibiotics and was discharged the following day. At 2 weeks' follow-up, he began a range of motion exercises, and by 4 weeks demonstrated excellent motion and a stable elbow joint. He continued non-surgical management with favorable early recovery.</p><p><strong>Conclusion: </strong>Open elbow dislocations in adults may occur after low-energy trauma and require a high index of suspicion, particularly when periarticular wounds are present. CT evaluation for intra-articular air is critical for identifying joint violation, and early operative washout with soft-tissue repair is essential to prevent infection and instability. This case underscores the importance of timely recognition and management to achieve optimal functional outcomes.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"16 10","pages":"137-141"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13646452/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149137202","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 Clinical and Radiological Assessment of Osteochondral Autograft Transfer for International Cartilage Repair Society Grade IV Osteochondral Lesions of the Knee.","authors":"Virender Kumar, Sarita Dhankhar, Radhika Devgan, Amitoj Singh, Ashish Devgan, Chetan Aggarwal","doi":"10.13107/jocr.2026.v16.i10.8296","DOIUrl":"10.13107/jocr.2026.v16.i10.8296","url":null,"abstract":"<p><strong>Introduction: </strong>Focal International Cartilage Repair Society (ICRS) Grade IV osteochondral lesions of the knee lead to pain, mechanical symptoms, and functional limitations in young active individuals. Osteochondral autograft transfer (OATS) repairs both hyaline cartilage and subchondral bone. This study assessed the clinical and radiological results of OATS in isolated Grade IV knee lesions.</p><p><strong>Materials and methods: </strong>This prospective cohort study involved 38 patients aged 15-40 years with isolated ICRS Grade IV osteochondral defects spanning 2.0-4.0 cm2. Out of these, 35 patients completed an 18-month follow-up. We evaluated functional outcomes using the Lysholm knee score, International Knee Documentation Committee (IKDC) subjective score, and Tegner activity scale before surgery and at 6, 12, and 18 months postoperatively. In addition, serial magnetic resonance imaging (MRI) scans were performed to monitor graft integration, surface alignment, structural issues, and degenerative changes.</p><p><strong>Results: </strong>The average age was 25.8 ± 5.6 years, with 76.3% being male. After 18 months, patients showed significant improvements: Lysholm scores increased from 50.29 ± 10.90 to 93.03 ± 4.11, IKDC scores from 48.29 ± 9.45 to 91.24 ± 4.55, and Tegner scores from 2.40 ± 0.60 to 8.71 ± 0.75. These improvements were statistically significant (P < 0.001). MRI results indicated graft healing in all patients, with 91.4% showing congruent articular surfaces and 8.6% exhibiting cystic degeneration or delamination. No graft failures or donor-site complications were observed.</p><p><strong>Conclusion: </strong>OATS achieved significant, lasting functional gains with consistent graft integration in carefully selected young patients suffering from moderate-sized isolated ICRS grade IV knee lesions, endorsing its effectiveness as a joint-preserving treatment option.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"16 10","pages":"384-391"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13646535/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149137192","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":"Digital Transformation in Orthopedics: Can India Leapfrog with Artificial Intelligence, Augmented Reality, and Robotics?","authors":"Kunal Aneja, Ponnanna Karineravanda Machaiah, Ashok Shyam","doi":"10.13107/jocr.2026.v16.i10.8166","DOIUrl":"10.13107/jocr.2026.v16.i10.8166","url":null,"abstract":"<p><p>Digital technologies are transforming orthopedic practice by improving diagnostic accuracy, surgical precision, and personalized patient care. Artificial intelligence, augmented reality, and robotics are increasingly integrated across the orthopedic continuum, enabling data-driven decision-making and reproducible surgical execution. India presents a unique opportunity to accelerate this transformation due to its high clinical volumes, expanding digital infrastructure, and growing ecosystem of indigenous innovation. However, challenges related to cost, infrastructure, workforce training, and governance remain significant. This editorial explores the opportunities, barriers, and strategic priorities for adopting digital technologies in orthopedics and discusses whether India can leapfrog conventional developmental pathways to establish an integrated, affordable, and patient-centered digital orthopedic ecosystem.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"16 10","pages":"6-10"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13646792/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149137072","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 Missing Dimension: Why Bidirectional Evaluation could be a Predictor of Hand Health.","authors":"Sagar Deshpande, Sachin Kale, Mugdha Oberoi, Ashok Shayam","doi":"10.13107/jocr.2026.v16.i10.8170","DOIUrl":"10.13107/jocr.2026.v16.i10.8170","url":null,"abstract":"","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"16 10","pages":"14-15"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13646455/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149137190","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":"Association between Coronal Mechanical Axis Correction and Early Functional Outcomes after Primary Total Knee Arthroplasty: A Retrospective Observational Study.","authors":"Aminuddin Qureshi, Nishat Faatima, Sandesh Subhash Agrawal","doi":"10.13107/jocr.2026.v16.i10.8332","DOIUrl":"10.13107/jocr.2026.v16.i10.8332","url":null,"abstract":"<p><strong>Introduction: </strong>Restoration of the mechanical axis is an important objective of primary total knee arthroplasty (TKA), although the relationship between the magnitude and pattern of post-operative alignment and early functional recovery remains incompletely defined. This study evaluated post-operative mechanical-axis restoration and its association with early functional outcomes following primary TKA.</p><p><strong>Materials and methods: </strong>This retrospective study included 60 patients (85 knees) undergoing primary TKA. Pre-operative and post-operative full-length radiographs were assessed for femorotibial mechanical axis (FTMA) and mechanical axis deviation (MAD). Post-operative FTMA was classified as valgus, neutral, mild varus, or severe varus. Functional outcomes were assessed using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Oxford Knee Score (OKS) preoperatively and at 6 weeks, 3 months, and 6 months. Patient-clustered analyses accounted for bilateral knees.</p><p><strong>Results: </strong>Mean FTMA improved from -10.13 ± 4.82° preoperatively to -1.49 ± 3.95° postoperatively (P < 0.001), while MAD decreased from 4.85 ± 2.17 to 1.61 ± 1.24 cm (P < 0.001). WOMAC improved from 76.21 ± 5.75 to 11.58 ± 4.35, and OKS increased from 10.98 ± 2.55 to 41.95 ± 3.35 at 6 months (both P < 0.001). Neutral alignment was associated with the best 6-month outcomes (WOMAC, 8.33 ± 2.13; OKS, 44.80 ± 1.65). Correction magnitude was not associated with WOMAC (P = 0.168) but was associated with OKS (P = 0.009). Correction of 5-10° resulted in higher OKS than correction >10° (P = 0.044).</p><p><strong>Conclusions: </strong>Primary TKA significantly improved mechanical alignment and functional outcomes. Neutral post-operative alignment was associated with better early function, while correction beyond 10° did not provide additional functional benefit.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"16 10","pages":"524-534"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13646809/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149136944","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":"Pertrochanteric Femur Fracture in a Post-Polio Patient treated with a Pediatric Hip Plate: A Case Report.","authors":"Benjamin Dietz, Marco Edgar Ariza, Michael Schneider","doi":"10.13107/jocr.2026.v16.i10.8180","DOIUrl":"10.13107/jocr.2026.v16.i10.8180","url":null,"abstract":"<p><strong>Introduction: </strong>Fracture fixation in post-polio residual paralysis is technically demanding due to dysplastic proximal femoral anatomy, osteopenia, and distorted trochanteric morphology. Standard cephalomedullary nailing may be impossible when the medullary canal is narrow, or the entry point is malpositioned.</p><p><strong>Case report: </strong>A 45-year-old man with childhood poliomyelitis and complete paralysis of the right leg sustained an AO 31-A1.2 pertrochanteric fracture. Radiographs revealed coxa valga and a markedly narrow canal, precluding safe cephalomedullary nailing. Closed reduction on a traction table required 35° internal rotation to achieve anatomical alignment. Fixation was performed with a Synthes Pediatric Hip Plate (120°, four-hole, 5.0 mm) through a lateral trans-muscular approach. The intraoperative course was uneventful. Postoperatively, partial weight bearing in the orthosis was initiated; radiographs confirmed stable reduction. At 6-week follow-up, the patient reported minimal pain, which subsequently resolved completely. By 3-month follow-up, radiographs demonstrated progressive but incomplete bony consolidation, with stable implant position and no evidence of implant loosening or loss of reduction.</p><p><strong>Conclusion: </strong>In adults with post-polio femoral dysplasia and canal stenosis, a pediatric LCP hip plate can provide a low-profile, angular-stable alternative when intramedullary fixation is anatomically contraindicated.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"16 10","pages":"40-44"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13646606/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149136759","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":"Prevalence and Clinical Impact of Lumbosacral Transitional Vertebrae in Chronic Low Back Pain: A Cross-Sectional Study from Central India.","authors":"Vipin Kumar Mishra, Jeetesh Gawande, Saumya Mishra","doi":"10.13107/jocr.2026.v16.i10.8338","DOIUrl":"10.13107/jocr.2026.v16.i10.8338","url":null,"abstract":"<p><strong>Introduction: </strong>Lumbosacral transitional vertebrae (LSTV) are common anatomical variants implicated in chronic low back pain (LBP). Their prevalence and clinical significance remain debated.</p><p><strong>Materials and methods: </strong>A hospital-based cross-sectional study was conducted among 350 consecutive adult patients (18-70 years) with chronic non-specific LBP at a tertiary care center in Central India. Demographic and clinical data were recorded, pain intensity assessed using the Visual Analog Scale (VAS), and disability quantified with the Oswestry Disability Index (ODI). Standardized lumbosacral radiographs were obtained and independently reviewed by experienced specialists. LSTV were classified according to Castellvi types. Statistical comparisons were performed between patients with and without LSTV, and across LSTV subtypes.</p><p><strong>Results: </strong>Of 350 patients, 198 (56.6%) were male; mean age was 42.8 ± 11.6 years. Radiographic LSTVs were identified in 78 patients, yielding a prevalence of 22.3%. Distribution by Castellvi type was: Type I (30.8%), Type II (25.6%), Type III (23.1%), and Type IV (20.5%). Patients with LSTV had significantly higher mean VAS (6.2 ± 1.4 vs. 5.4 ± 1.6; P = 0.002) and ODI scores (34.8 ± 9.7 vs. 29.1 ± 10.2; P = 0.001) compared to those without. High-grade LSTV (Types II-IV) were associated with greater pain and disability than low-grade variants (P < 0.05). ANOVA confirmed significant differences in ODI across Castellvi types, with Type III and IV showing the highest disability.</p><p><strong>Conclusion: </strong>LSTV were present in nearly one-fourth of patients with chronic LBP and were associated with significantly greater pain and disability, particularly in high-grade variants. Recognition of LSTV may aid in clinical evaluation and management of chronic LBP.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"16 10","pages":"550-554"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13646789/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149137212","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}