Journal of Orthopaedic Case Reports最新文献

{"title":"Comparative Efficacy and Safety of Fluoroscopy-guided Caudal Epidural Steroid Injection and Transforaminal Epidural Steroid Injection for Unilateral L5-S1 Paracentral Discogenic Radicular Pain.","authors":"Sathish Muthu, Praveen Thangavel, Sivaraman Duraisamy, Arun Anand Palaniappan","doi":"10.13107/jocr.2025.v15.i02.5296","DOIUrl":"10.13107/jocr.2025.v15.i02.5296","url":null,"abstract":"<p><strong>Introduction: </strong>Epidural steroid injection (ESI) is one of the key management strategies in the management of discogenic radicular pain. This study aims to compare the efficacy and safety of fluoroscopy-guided ESI through caudal (cESI) and transforaminal (tfESI) routes for unilateral paracentral L5-S1 discogenic radicular pain.</p><p><strong>Materials and methods: </strong>This prospective non-randomized comparative study conducted between January 2023 and January 2024 in a tertiary care hospital included patients presenting with unilateral paracentral L5-S1 discogenic radicular pain who failed 6 weeks of conservative care. The pain and functional outcome was analyzed using numerical pain rating scale (NPRS) and Oswestry disability index, respectively, at baseline, 3-week, 6-week, and 6-month post-intervention. Procedure failure is defined as NPRS score improvement <50% or ODI improvement <40% of baseline. Other outcomes analyzed were the duration of the procedure, and fluoroscopy shots used during the procedure.</p><p><strong>Results: </strong>We enrolled 60 patients in the study, 54 patients were available till the final follow-up with 26 patients in the cESI group and 28 patients in the tfESI group. The mean age of the cESI group (M: F 12:14) and tfESI group (M:F 10:18) was 36.1 (±4.1) years and 38.9 (±3.9) years, respectively. The pain and functional scores were significantly reduced compared to the baseline scores in both the groups (P < 0.001) and the reduction between the two groups was comparable at every follow-up. The tfESI group experienced significantly more failures (n = 8) at 6 months compared to the cESI group (n = 2) (P = 0.048). The tfESI group had significantly longer mean procedure time (18.8 min) and more fluoroscopy usage (16 shots) compared to cESI group with mean procedure time of 13 min (P = 0.014) and fluoroscopy usage of 10 shots (P = 0.023), respectively. No major adverse events were reported for either of the groups.</p><p><strong>Conclusion: </strong>cESI is a simple, safe, and efficacious technique comparable to tfESI in the management of unilateral L5-S1 paracentral discogenic radicular pain with significantly less procedural time and fluoroscopy usage. Further, large-scale studies are needed to validate the study results.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 2","pages":"239-248"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11823847/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433297","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":"Revision Reverse Total Shoulder Arthroplasty Combined With Secondary Pectoralis Major Transfer for Tray-Taper Breakage and Internal Rotational Dysfunction: A Case Report.","authors":"Chang Hee Baek, Bo Taek Kim, Jung Gon Kim","doi":"10.13107/jocr.2025.v15.i02.5218","DOIUrl":"10.13107/jocr.2025.v15.i02.5218","url":null,"abstract":"<p><strong>Introduction: </strong>Reverse total shoulder arthroplasty (RTSA) has become a pivotal intervention for managing rotator cuff arthropathy in the elderly, showing consistent improvements in pain relief and shoulder function. However, the broad spectrum of indications for RTSA is accompanied by a notable incidence of complications, prompting continuous advancements in technology and surgical techniques.</p><p><strong>Case report: </strong>This case report presents an uncommon complication rarely discussed in the existing literature - humeral tray-taper breakage after RTSA. The patient, a 68-year-old with a history of rotator cuff repair surgery, underwent RTSA with concurrent subscapularis repair due to rotator cuff arthropathy. Postoperatively, the patient gradually reported weakness in internal rotation (IR), leading to a subsequent secondary pectoralis major (PM) transfer. However, following an incident where the patient experienced acute pain due to a slip, a tray-taper breakage in the implant was revealed. To address the broken implant and the weakness in IR, the patient underwent revision RTSA combined with the PM transfer. With a post-operative rehabilitation program, at 1 year and 6 months postoperatively, the patient demonstrated significant pain relief and improved functional outcomes.</p><p><strong>Conclusion: </strong>The case report underscores the importance of recognizing and addressing rare complications associated with RTSA, providing insights into the management of humeral tray-taper breakage. Furthermore, combined PM transfer to RTSA could be a solution to weakness in IR. This case report emphasizes the need for careful consideration of potential complications and innovative solutions for optimal patient outcomes.</p><p><strong>Level of evidence iv: </strong>Case report.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 2","pages":"32-36"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11823865/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433404","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":"Tuberculous Osteomyelitis of the Coracoid Process Presenting as Shoulder Pain: A Case Report.","authors":"Rahul Shah, Aditya Rao, Siddharth Gunay, Shradha Kulkarni","doi":"10.13107/jocr.2025.v15.i02.5278","DOIUrl":"10.13107/jocr.2025.v15.i02.5278","url":null,"abstract":"<p><strong>Introduction: </strong>India accounts for more than 25% of the global cases of tuberculosis (TB). Skeletal TB accounts for approximately 15% of extra-pulmonary TB cases and up to 5% of all TB cases. Spine is the most common site for osteoarticular TB accounting for half of the total osteoarticular TB cases. TB osteomyelitis of flat bones such as the scapula is uncommon. The risk of TB among healthcare workers is significantly higher as compared to the general population. This is of particular concern, especially in endemic countries.</p><p><strong>Case report: </strong>A 26-year-old doctor presented with a 1-month history of dull-aching right shoulder pain without constitutional symptoms. The patient had tenderness over coracoid process on deep palpation with no other positive findings. Plain radiographs were unremarkable but magnetic resonance imaging revealed osteomyelitic changes in the coracoid process which was confirmed as TB on histopathology. The patient had excellent outcome after 18 months of anti-tuberculous therapy.</p><p><strong>Conclusion: </strong>A high index of suspicion of TB is imperative in endemic countries, especially in healthcare workers, irrespective of the immunity, vaccination status, and radiographic appearance. Early diagnosis and timely treatment give excellent functional outcomes.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 2","pages":"188-192"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11823887/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433478","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 Role of Computed Tomography in Achieving True External Rotation in Robotic Knee Replacement: A Retrospective Analysis of 300 Knees.","authors":"Pramod Bhor, Sawankumar Pawar, Syed Ali, Arvind Vatkar, Sachin Kale, Dnyanada Kutumbe","doi":"10.13107/jocr.2025.v15.i02.5304","DOIUrl":"10.13107/jocr.2025.v15.i02.5304","url":null,"abstract":"<p><strong>Introduction: </strong>Midflexion gap (MFG) malalignment remains a challenge in total knee arthroplasty (TKA), often attributed to inaccurate femoral component positioning. Precise determination of true external rotation (TER) is crucial for optimal implant orientation and MFG reduction. This study aimed to evaluate the utility of computed tomography (CT)-based TER measurement in robotic knee replacements.</p><p><strong>Materials and methods: </strong>A retrospective analysis was conducted on data from 300 patients who underwent robotic TKA using a system that incorporates CT-derived bone models. TER was measured preoperatively on CT scans.</p><p><strong>Results: </strong>The mean posterior condylar angle (PCA) (n = 300) between the transepicondylar axis (TEA) and the posterior condylar axis was 2.87 ± 0.73° (95% confidence interval [CI]) with a range of 2.14-3.6°. The external rotation between the anatomical and surgical TEA is 1.19 ± 0.94° (95% CI) with a range of 0.25-2.13°. Intraclass correlation coefficient for the angle is 1 (TEA) and 0.98 (PCA). This highlights potential discrepancies between traditional radiographic measurements and actual TER. Femoral component positioning aligned closer to the CT-based TER compared to standard methods. In addition, a significant reduction in MFG was observed in knees with TER-guided implant placement.</p><p><strong>Conclusion: </strong>CT-based TER measurement provides a more accurate assessment of femoral rotation compared to conventional radiographs. This improved precision translates into optimal implant positioning and significantly reduces MFG malalignment in robotic knee replacements. Our findings suggest that incorporating CT-based TER into the workflow can enhance the accuracy and outcomes of robotic TKA.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 2","pages":"269-274"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11823844/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433463","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 Complication of Hook Plate Fixation for Lateral Clavicle Fractures: Salvage Management with K-Wire Fixation.","authors":"Sunit Kumar Pani, Subrat Mohapatra, Spandan Mishra, Ramanuj Acharya, Chaitanya Khandelwal","doi":"10.13107/jocr.2025.v15.i02.5234","DOIUrl":"10.13107/jocr.2025.v15.i02.5234","url":null,"abstract":"<p><strong>Introduction: </strong>Hook plate fixation is a widely used technique for managing lateral clavicle fractures, particularly when the coracoclavicular ligaments are disrupted. However, improper placement of the hook plate can result in rare and challenging complications that require innovative management strategies. This report presents a unique case involving such a complication and describes a minimally invasive, single-stage salvage approach using K-wire fixation to effectively address the issue.</p><p><strong>Case report: </strong>A 45-year-old female presented with pain and restricted shoulder function due to a hook plate positioned incorrectly at the fracture site rather than in the acromioclavicular joint. The mispositioned plate was carefully removed, and the fracture was stabilized using K-wire fixation.</p><p><strong>Results: </strong>At the 6-month follow-up, the patient had excellent functional recovery with a Constant-Murley score of 89 and complete radiographic union at the fracture site.</p><p><strong>Conclusion: </strong>This case highlights a rare issue that can occur when a hook plate is not placed correctly. It shows how important it is to position hardware accurately. The case also illustrates how a minimally invasive technique, using K-wire stabilization, can effectively manage these types of complications.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 2","pages":"76-79"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11823842/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433277","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":"Arthroscopic Management of Snapping Scapular Syndrome due to Recalcitrant Scapulothoracic Bursitis - A Case Series.","authors":"Raghavendra Kembhavi, Jojin Jose Chitten, Nagesh M Inginshetty","doi":"10.13107/jocr.2025.v15.i02.5290","DOIUrl":"10.13107/jocr.2025.v15.i02.5290","url":null,"abstract":"<p><strong>Introduction: </strong>Snapping scapula syndrome (SSS) is a rare pathological condition characterized by palpable and/or audible crackling sensation during scapulothoracic movements. Scapulothoracic bursitis with or without osseous lesions is commonly associated with this syndrome. The initial management is always non-operative methods with anti-inflammatory medications and physiotherapy modalities. However, if the symptoms persist beyond 3-6 months of non-surgical treatment, it should be categorized as refractory or recalcitrant bursitis and necessitate either open or arthroscopic surgical excision of the lesion.</p><p><strong>Case report: </strong>We successfully managed five patients with SSS with arthroscopic scapulothoracic bursectomy.</p><p><strong>Conclusion: </strong>Arthroscopic scapulothoracic bursectomy is a successful surgical intervention for patients with scapulothoracic bursitis who do not respond to the conservative mode of management.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 2","pages":"221-226"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11823871/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433291","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":"Is Native Joint Line More Accurately Restored with Robotic Assisted Total Knee Arthroplasty than with Conventional Instruments?","authors":"Pramod Bhor, Sawankumar Pawar, Dnyanada Kutumbe, Arvind Vatkar, Sachin Kale, Rahul Jagtap","doi":"10.13107/jocr.2025.v15.i02.5294","DOIUrl":"10.13107/jocr.2025.v15.i02.5294","url":null,"abstract":"<p><strong>Introduction: </strong>Changes in joint line (JL) position after total knee arthroplasty (TKA) have revealed implant failure, diminished knee function, and altered knee biomechanics. The purpose of this study was to compare the joint line restoration of robotic-assisted TKA (RA-TKA) and conventional TKA (c-TKA).</p><p><strong>Materials and methods: </strong>In a prospective cohort study trial, trained fellows performed radiographic analyses on patients receiving RA-TKA (group-1) and c-TKA (group-2) to quantify joint line using the adductor tubercle method. Statistical analysis was used using t-tests, with statistical significance defined as a P < 0.005.</p><p><strong>Results: </strong>The study contained 150 RA-TKAs and 150 total C-TKAs. Both groups were comparable in demographics such as age, gender, and body mass index. On average, RA-TKAs resulted in a 1.65 ± 0.46 mm shift in the JL position, while C-TKAs resulted in a 2.52 ± 0.52 mm change (P = 0.000). The interclass correlation coefficient between the robotic and conventional groups is around 0.992.</p><p><strong>Conclusion: </strong>RA-TKA restores the JL position better than C-TKA, which appears to depend on precise planning and ligament balancing, which is attainable with robotic-aided surgery. The clinical relevance of this statistically significant difference requires additional investigation.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 2","pages":"233-238"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11823860/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433316","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":"Longitudinal Management of Progressive Femoral Deformities in a Pediatric Patient: A Case Study on Adaptative Surgical Interventions and Outcomes.","authors":"Asad Khan, Yasir Salam Siddiqui, Mohammad Baqar Abbas, Ahsan Firoz, Mohammad Arshad Rahman, Mamoon Rashid","doi":"10.13107/jocr.2025.v15.i02.5280","DOIUrl":"10.13107/jocr.2025.v15.i02.5280","url":null,"abstract":"<p><strong>Introduction: </strong>Pediatric femoral deformities present unique challenges in orthopedics, requiring careful management to accommodate ongoing growth and development in young patients. This case report illustrates the longitudinal treatment of a child who experienced multiple complications following an initial femoral neck fracture in a cystic lesion, highlighting the complexity of managing such conditions over time.</p><p><strong>Case report: </strong>A 4-year-old child presented in 2016 with a femoral neck fracture and a cystic lesion in the proximal femur, initially managed with valgus osteotomy and dynamic compression plate fixation. Two years later, the patient exhibited a malunited fracture leading to coxa vara, which was managed by implant removal. In 2021, the child developed a bowing deformity which was corrected operatively with another osteotomy and TENS wire insertion. The most recent intervention in 2022 involved a valgus osteotomy and fixation with a dynamic hip screw to address persistent coxa vara, resulting in a successful union.</p><p><strong>Conclusion: </strong>This case emphasizes the need for ongoing, adaptive management strategies in pediatric orthopedics, particularly for patients with complex femoral deformities. Each surgical intervention was tailored to the child's evolving anatomical needs, with close follow-up to ensure optimal outcomes as the patient grew. The multidisciplinary approach and continuous reassessment are critical in achieving favorable long-term results in similar pediatric cases.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 2","pages":"193-197"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11823874/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433320","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":"Novel Case of Ipsilateral Supracondylar Fracture with Distal Radio-Ulna Fracture with Acute Compartment Syndrome: A Rare Case Report.","authors":"Sumedh D Chaudhary, Akshay Phupate, Nilesh S Sakharkar, Karan R Lakhani","doi":"10.13107/jocr.2025.v15.i02.5232","DOIUrl":"10.13107/jocr.2025.v15.i02.5232","url":null,"abstract":"<p><strong>Introduction: </strong>Fractures involving the supracondylar or distal end radius are the most common fracture in pediatric population. Although they have similar mechanisms of injury, i.e., hyperextension, they occur in isolation and combined supracondylar and distal end radius injuries in the same limb are extremely uncommon. We are reporting an extremely rare clinical presentation of a child with ipsilateral supracondylar fracture with fracture of distal end radius and ulna associated with acute compartment syndrome (ACS).</p><p><strong>Case report: </strong>A 13-year-old male had sustained trauma to left upper limb due to fall from tree. He was initially treated elsewhere with suturing of wound over his forearm and was brought to our emergency room after 12 h with complaints of swelling and severe pain in left arm, forearm, and hand. On clinical examination, there was tense swelling over the left arm, forearm, and hand. Passive stretch pain was present. Limb was warm, there were multiple blisters present over the flexor aspect over anti-cubital fossa of the left limb. On vascular and neurological evaluation, sensation was decreased compared to other limb over the volar aspect of the hand and forearm, also the pulses were feeble. The patient was immediately sent for Doppler of the left upper limb which showed biphasic flow. X-rays revealed ipsilateral left supracondylar humerus fracture (Type 4 according to Gartland Classification) with distal end radius and distal ulna fracture. As the patient had developed ACS which was evident from the tense swelling and passive stretch pain, we decided to urgently operate the patient with fasciotomy followed by fracture fixation. Wound was closed by shoelace suturing technique, and then, split-thickness skin grafting was done. K-wires were after a period of 6 weeks and gradual range of motion exercises was started.</p><p><strong>Conclusion: </strong>Ipsilateral supracondylar with distal end radius with ACS is a rare entity. ACS should be given priority and fasciotomy must be done properly so as to ensure adequate decompression of intercompartmental pressure. This should be followed by fixation of the fractures. If appropriate intervention is done urgently, good results can be achieved even in such challenging injuries.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 2","pages":"70-75"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11823859/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433399","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":"Outcomes of Combined Distal Femur Plating and Retrograde Femur Nailing in Comminuted Distal Femur Fractures: Case Series of Seven Cases with 6 Months Follow-up.","authors":"Sachin Kale, Shikhar Singh, Arvind Vatkar, Rohan Jayaram, Sonali Das, Ashmit Verma","doi":"10.13107/jocr.2025.v15.i02.5284","DOIUrl":"10.13107/jocr.2025.v15.i02.5284","url":null,"abstract":"<p><strong>Introduction: </strong>This study evaluates the functional outcomes of combining distal femur plating with retrograde femur nailing in treating comminuted distal femur fractures.</p><p><strong>Case report: </strong>A retrospective analysis was conducted on patients treated at a tertiary health care center from January 1, 2023, to November 30, 2023. The cohort comprised patients with an average age of 54.57 years (standard deviation [SD] = 13.34) and a male-to-female ratio of 3:4. The primary outcome measure was knee range of motion (ROM). At the 1.5-month follow-up, the average knee flexion was 54° (SD = 13.46). This improved to 110° (SD = 8.7) at 3 months and to 138.6° (SD = 7.34) at the 6-month follow-up. These findings indicate significant improvement in knee function over the study period. All patients showed union at fracture sites at the end of 6 months.</p><p><strong>Conclusions: </strong>The combination of distal femur plating and retrograde femur nailing demonstrates promising functional recovery in knee ROM for patients with comminuted distal femur fractures. This surgical approach may offer an effective strategy for enhancing post-operative outcomes in this patient population.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 2","pages":"203-208"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11823837/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433436","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}