Journal of Orthopaedic Case Reports最新文献

{"title":"Perioperative Considerations for a Patient with Juvenile Idiopathic Scoliosis and Kaposiform Lymphangiomatosis Undergoing Spinal Fusion: A Case Report.","authors":"John P Avendano, Raisa Rauf, Barbara Vickers, Anisha Tyagi, Paul D Sponseller, Joann B Hunsberger","doi":"10.13107/jocr.2025.v15.i05.5572","DOIUrl":"https://doi.org/10.13107/jocr.2025.v15.i05.5572","url":null,"abstract":"<p><strong>Introduction: </strong>Kaposiform lymphangiomatosis is a lymphatic anomaly that, when symptomatic, presents in children at a median age of 6.5 years. Symptoms may include respiratory issues, palpable masses, and hemostatic abnormalities. Kaposiform lymphangiomatosis can be life-threatening due to diffuse tissue expansion and subsequent invasion of surrounding organs and tissues. Initial detection of this rare condition can be difficult due to the varied nature of its presenting symptoms and the overall lack of familiarity of clinicians with the condition. Consequently, misdiagnoses can occur, such as pneumonia, cancer, or other vascular anomalies. When considering operative treatment in patients with kaposiform lymphangiomatosis, meticulous pre-operative planning and multidisciplinary care are required due to the high risks of morbidity and death from blood loss. To the best of our knowledge, this is the first reported case of kaposiform lymphangiomatosis in a patient with juvenile idiopathic scoliosis.</p><p><strong>Case report: </strong>We present the case of a 13-year-old boy diagnosed with kaposiform lymphangiomatosis at age 8 who, after being followed for several years in our orthopedic clinic for worsening juvenile idiopathic scoliosis despite brace wear, underwent posterior spinal fusion with minimal complications (i.e.., minor cerebrospinal fluid leak). The patient had also been followed for several years before his kaposiform lymphangiomatosis diagnosis for unexplained thrombocytopenia, fatigue, and joint pain. Interdisciplinary care involved multiple specialist teams to choose appropriate pre-operative medications, induction protocol, and bone graft.</p><p><strong>Conclusion: </strong>Successful operative treatment in a patient with kaposiform lymphangiomatosis can be achieved with the involvement of an interdisciplinary team, anticipation and preparation for cardiac and pulmonary complications via chest tubes and pericardial windows, setting goal parameters to guide intraoperative monitoring, and ceasing medications such as sirolimus to prevent wound-related complications. Given the lack of a current standard of care for managing patients with kaposiform lymphangiomatosis who have spinal deformity, this report can serve as a guide that sets a benchmark for the management of similar cases.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 5","pages":"103-108"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12064260/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144025612","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":"Challenging Case of Sitting Imbalance as an Indication of Surgery for Grotesque Congenital Deformity of Spine - A Case Report.","authors":"Jeevan Kumar Sharma, Kalidindi Kalyan Kumar Varma, Abhinandan Reddy Mallepally, Padmini Yadav, Arun Sharma, Gururaj Mallikarjun Sangodimath","doi":"10.13107/jocr.2025.v15.i05.5558","DOIUrl":"https://doi.org/10.13107/jocr.2025.v15.i05.5558","url":null,"abstract":"<p><strong>Introduction: </strong>Sitting imbalance due to spinal deformity as an indication of surgery is very rarely encountered.</p><p><strong>Case report: </strong>We came across a very peculiar case of spinal deformity case who was wandering in search of treatment around multiple centers. The main concern for this 16-year-old boy from Yemen, who was born with congenital deformity with myelomeningocele and paraplegia, was sitting imbalance, which developed 2 months before presentation to our institute. Patient underwent a thorough clinical, radiological and multimodality assessment. Staged procedure of diastematomyelia excision followed by definitive posterior deformity correction was performed. Postoperatively, the patient's sitting balance was restored with no complications.</p><p><strong>Conclusion: </strong>Sitting imbalance can be an indication of surgery with congenital complicated kyphoscoliosis. With proper planning and staged management, the sitting balance could be achieved.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 5","pages":"65-69"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12064245/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029953","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":"Temporal Patterns of Trauma Mortality and Causes of Death in a Level 1 Trauma Center: Implications for Improved Trauma Care.","authors":"Rahul Sreenivasan Thokaloath, Shajimon Samuel, B P Vinod Kumar","doi":"10.13107/jocr.2025.v15.i05","DOIUrl":"https://doi.org/10.13107/jocr.2025.v15.i05","url":null,"abstract":"<p><strong>Introduction: </strong>Trauma mortality patterns have evolved over time, with distinct phases of immediate, early, and late deaths. Advances in trauma care and changing injury dynamics have contributed to shifts in this pattern. Understanding the causes and timing of trauma deaths is pivotal for enhancing trauma care systems.</p><p><strong>Materials and methods: </strong>We conducted a retrospective analysis of trauma deaths in 2020-2022 at a level 1 trauma center. Trauma death data were collected from case records, wound certificates, and death certificates. The time of death from trauma was calculated and deaths were categorized into immediate, early (within 24 h), and late (after 24 h) groups. Statistical analyses, including Chi-square tests, were performed to assess associations.</p><p><strong>Results: </strong>Of the 186 trauma deaths studied, 86.6% were males, and the mean age was 40 ± 16.91 years. Immediate deaths were predominantly due to brain injury (BI) (54.8%), thoracic injury (17.9%), and spinal cord injury (16.7%). Early deaths were mainly attributed to BI (35.1%) and poly-trauma (35.1%). Late deaths (after 24 h) were primarily a result of multiple organ failure (44.4%) and sepsis (24.4%). The analysis showed a significant association between the cause of death and time from trauma to death (P < 0.001).</p><p><strong>Conclusion: </strong>BI emerged as the leading cause of trauma-related deaths, with a progressive decline pattern observed in a well-established trauma care center. Immediate deaths can potentially be reduced through trauma prevention strategies, particularly in the context of high-speed vehicles and machinery. These findings underscore the importance of timely interventions, effective critical care, and continuous improvements in trauma care systems.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 5","pages":"240-247"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12064228/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144022739","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 Novel Variant of Suprascapular Neurovascular Morphology: Clinical and Surgical Implications.","authors":"Jordan Konstanty, Robert J Heins, Nicholas Donohue, Bryan G Beutel","doi":"10.13107/jocr.2025.v15.i05.5594","DOIUrl":"https://doi.org/10.13107/jocr.2025.v15.i05.5594","url":null,"abstract":"<p><strong>Introduction: </strong>The suprascapular neurovascular structures traverse the suprascapular notch in a variety of morphologies. However, the suprascapular nerve has always been described as coursing under the superior transverse scapular ligament (STSL) at the level of the notch. This report aims to describe a novel variant of suprascapular neurovascular structures found in a cadaver.</p><p><strong>Case report: </strong>During the dissection of a cadaveric upper extremity in an 85-year-old Caucasian male, the suprascapular nerve, artery, and vein were found to course above the STSL, with no structures passing through the foramen of the notch itself. A total of 94 upper extremities from 52 different cadavers were subsequently examined for the morphology of the suprascapular nerve, artery, and vein at the level of the suprascapular notch. No other cadavers were found to have this morphology, thereby resulting in an estimated prevalence of 1.1%.</p><p><strong>Conclusion: </strong>This case study describes this unique unilateral shoulder anomaly, reviews the relevant literature, and discusses the potential clinical significance of this variant, which should be considered during various posterior shoulder surgeries or peripheral nerve blocks wherein aberrant morphology can increase the risk of neurovascular complications.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 5","pages":"156-160"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12064265/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144016291","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":"Trimalleolar Fracture of the Bilateral Ankles: A Rare Case Report.","authors":"Sahil D Kale, Sumit Saurabh, Ravi Jatti, Sachin Kale, Arvind Vatkar","doi":"10.13107/jocr.2025.v15.i05.5578","DOIUrl":"https://doi.org/10.13107/jocr.2025.v15.i05.5578","url":null,"abstract":"<p><strong>Introduction: </strong>Ankle fractures are the second most common lower limb fracture after hip fractures. The injuries occur under a variety of conditions such as falls, sports, and road traffic accidents irrespective of age and sex. We report a rare case of trimalleolar fracture of bilateral ankles.</p><p><strong>Case report: </strong>A 20-year-old girl came to casualty with an alleged history of falling from height in December 2023. After which she sustained injuries over her both ankle joints with no history of any head injury. The patient was examined clinically and radiologically. She was diagnosed with a bilateral trimalleolar fracture. The patient underwent bilateral open reduction and internal fixation of the ankle fractures. The procedures were performed sequentially in a staged procedure. The postoperatively patient was followed up for 1 year.</p><p><strong>Conclusion: </strong>This case highlights the management and outcome of bilateral ankle trimalleolar fractures, which is one of the rare cases, following a traumatic fall. Multidisciplinary care is essential for achieving optimal outcomes and ensuring an early return to function for patients with such injuries.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 5","pages":"119-122"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12064261/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143976728","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":"Atypical Presentation of Behcet's Disease with Atlanto Axial Joint Pain as Initial Presentation-A Case Report.","authors":"Sl Sujitha Reddy, B Sathish Pai, N Shyamasunder Bhat, Kanthilatha Pai","doi":"10.13107/jocr.2025.v15.i05.5538","DOIUrl":"https://doi.org/10.13107/jocr.2025.v15.i05.5538","url":null,"abstract":"<p><strong>Introduction: </strong>Behcet's disease (BD) is a chronic and multi-systemic disorder with inflammatory characteristics. It is manifested by recurrent oral aphthae, skin lesions, ocular disease, gastrointestinal involvement, neurological disorders, and vascular disease. Arthritis is seen in half of the patients. However, it rarely affects the spinal column, and patients presenting with neck pain have been reported only in one case in the literature.</p><p><strong>Case report: </strong>Here we report a case of 39 year old male patient with BD whose primary symptom was neck pain. Anti-tubercular therapy was started empirically suspecting cervical tuberculosis. He was further evaluated as he was also developing skin and oral lesions. He was diagnosed to be having Behcet's disease and was started on colchicine, with which both his skin lesions and neck pain improved symptomatically.</p><p><strong>Conclusion: </strong>This case emphasizes that despite atlanto-axial joint pain is a rare manifestation of BD, clinicians should suspect it a differential diagnosis in patients with neck joint pain along with mucous or cutaneous lesions. Accurate diagnosis and early management have to be done to prevent further joint dislocation and associated fatalities.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 5","pages":"16-19"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12064258/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143970433","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":"Simultaneous Bilateral Patellar Tendon Ruptures Treated with Primary Repair and Dermal Allograft Augmentation: A Case Report.","authors":"Tyler Small, Michael Reen, Kyle Mahoney, Karl Siebuhr","doi":"10.13107/jocr.2025.v15.i05.5548","DOIUrl":"https://doi.org/10.13107/jocr.2025.v15.i05.5548","url":null,"abstract":"<p><strong>Introduction: </strong>Patellar tendon ruptures are a relatively common injury encountered by orthopedic surgeons and typically only occur unilaterally. However, there are rare reports of bilateral patellar tendon ruptures occurring simultaneously, in patients with underlying systemic disorders, higher energy mechanisms, or injury or overuse in high-level athletes. When patellar tendon ruptures occur, and the extensor mechanism is disrupted, patellar tendon repair versus reconstruction is warranted to restore functionality. The use of dermal allografts for the reconstruction of chronic patellar tendon ruptures is well described; however, there is not much literature describing their use in the acute setting. This report describes the primary repair of simultaneous bilateral patellar tendon rupture with the use of the ArthroFLEX Decellularized Dermal Allograft. This is a novel use for this allograft, as it is currently indicated for use in the treatment of various tendon repairs/reconstructions as well as hallux rigidus and hip capsule reconstruction. There are no reports describing the use of the ArthroFLEX Decellularized Dermal Allograft in the acute setting as augmentation of primary patellar tendon repair in a patient with simultaneous bilateral patellar tendon ruptures in the absence of underlying systemic disease; thus, this report presents a novel use for this dermal allograft.</p><p><strong>Case report: </strong>This patient is a 40-year-old African American male with no active underlying systemic diagnosis who sustained simultaneous bilateral patellar tendon ruptures from a low-energy mechanism. He subsequently underwent bilateral patellar tendon repair during which a dermal allograft augment was utilized to further strengthen this repair. In addition, a defunctioning purse string suture was used to further protect the patellar tendon repair by off loading the extensor mechanism.</p><p><strong>Conclusion: </strong>This report adds to the body of literature surrounding the rare entity of simultaneous bilateral patellar tendon ruptures in otherwise healthy patients while also presenting a novel use for the ArthroFLEX Decellularized Dermal Allograft in the acute repair of a patellar tendon rupture. This report also supports the use of a defunctioning purse string suture to help offload the healing extensor and decrease the amount of tension across a healing tendon repair.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 5","pages":"37-42"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12064259/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144012296","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":"Talus with Trimalleolar Fracture: A Three-planar Injury of Ankle Joint Complex: A Unique Case Report.","authors":"Santanu Kar, A S Pon Aravindhan, Ritvik Janardhanan, Nitish Jagdish Jyoti, Vijay Sharma, Madhan Jeyaraman","doi":"10.13107/jocr.2025.v15.i05.5586","DOIUrl":"https://doi.org/10.13107/jocr.2025.v15.i05.5586","url":null,"abstract":"<p><strong>Introduction: </strong>Malleolar fractures are common, often bimalleolar/trimalleolar. Talus fractures are rare, with risks like avascular necrosis (AVN). Unique challenges arise, especially in combined injuries, sometimes needing ankle arthrodesis.</p><p><strong>Case report: </strong>An 18-year-old male laborer presented with a history of fall from height and sustained injury over the right ankle. Imaging showed a talar body fracture with a trimalleolar fracture on the same ankle. After the subsidence of swelling at 9 days, the patient underwent open reduction and internal fixation using screws and plates for malleolar fracture and Herbert screw for talus fracture. At 1-year follow-up, the patient had adequate range of motion of the ankle which was painless without any signs of AVN. The patient underwent ankle arthrodesis at 5 years old as he developed severe pain in the joint. After 1 year of arthrodesis, the patient has pain-free motion of the ankle joint.</p><p><strong>Conclusion: </strong>Such fractures are rare with a unique mechanism of injury. There are chances of arthritis and instability owing to the variable cartilage damage and occult ligament injury. Stress radiographs after fracture union can help predict ankle instability. Internal fixation is the method of treatment in the acute setting, though the chances of late arthritis are high.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 5","pages":"136-140"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12064227/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143972357","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 Giant Cell Tumor of 1st Metatarsal in a Young Adult: A Rare Versatile Management with Fibula Cortical Graft.","authors":"K R Shamanth, P Shivanna","doi":"10.13107/jocr.2025.v15.i05.5598","DOIUrl":"https://doi.org/10.13107/jocr.2025.v15.i05.5598","url":null,"abstract":"<p><strong>Introduction: </strong>Giant cell tumor is a benign aggressive tumor commonly affecting the 2nd decade. Most commonly seen in the ends of long bones like the distal femur, proximal tibia, distal radius, and proximal humerus, but it does occur in small bones like hands and feet in <2%.</p><p><strong>Case report: </strong>A young female adult of age 23 has been diagnosed with a giant cell tumor of her 1st metatarsal and underwent complete excision with reconstruction with non-vascularized autogenous cortical fibula strut graft using a reconstruction plate and screws and 1-year follow-up showed a good graft union and no signs of recurrence.</p><p><strong>Conclusion: </strong>Local resection of the affected metatarsal combined with chemoablation reduces recurrence risk, while a fibula graft offers structural stability. In our case, there were no signs of recurrence, and the graft showed good incorporation.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 5","pages":"165-170"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12064238/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144019152","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":"Induced Membrane Wrist Fusion with Ring External Fixator Assistance in a Mangled Upper Extremity: A Case Report.","authors":"Caleb Shin, Hans Drawbert, John Riehl, John Badylak","doi":"10.13107/jocr.2025.v15.i05.5600","DOIUrl":"https://doi.org/10.13107/jocr.2025.v15.i05.5600","url":null,"abstract":"<p><strong>Introduction: </strong>In the mangled forearm injury, a decision between limb salvage or amputation must be made.</p><p><strong>Case report: </strong>This case report highlights a 37-year-old patient that sustained a mangled wrist injury with a substantial amount of bone loss to the distal radius after an All-Terrain Vehicle (ATV) rollover accident. The decision for limb salvage was made and he was treated with the induced membrane technique with wrist arthrodesis using a ring external fixator with a satisfactory outcome.</p><p><strong>Conclusion: </strong>This case report demonstrates the successful use of the induced membrane technique with a ring external fixator as a limb salvage technique to achieve wrist fusion in a mangled extremity with segmental bone loss.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 5","pages":"171-176"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12064236/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144031362","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}