Journal of Orthopaedic Case Reports最新文献

{"title":"First Documented Hip Replacement in a Palestinian Patient with Ochronotic Alkaptonuria Arthropathy: A Case Report.","authors":"Saleh Shalalfa, Neveen Shalalfa, Javid Mohammadzadeh Azarabadi, Ahmed Nafiz Barakat","doi":"10.13107/jocr.2025.v15.i03.5356","DOIUrl":"https://doi.org/10.13107/jocr.2025.v15.i03.5356","url":null,"abstract":"<p><strong>Introduction: </strong>Alkaptonuria (AKU) is a genetic disease caused by a deficiency in the homogentisate 1,2-dioxygenase enzyme. This deficiency leads to elevated levels of homogentisic acid and its oxidized form, benzoquinone acetic acid. Together, these substances lead to the bluish-black coloring of the bone and cartilage, along with calcification, inflammation, degeneration, and ultimately osteoporosis. The accumulation of pigments in the spine and major joints can result in ochronotic degenerative arthropathy.</p><p><strong>Case report: </strong>In this study, we present the case of a 65-year-old Palestinian man who exhibited musculoskeletal manifestations of AKU for 15 years. He was successfully treated with hip replacement, and we conducted a literature analysis to provide a comprehensive summary of the etiology, clinical characteristics, and potential treatments.</p><p><strong>Conclusion: </strong>AKU affects the spine and large joints. At present, there is no cure for this condition. A diet low in Vitamin C, antioxidants, tyrosine, and phenylalanine may delay the progression of AKU, but the long-term consequences are still unknown. Joint replacement may be recommended to relieve joint pain and improve mobility.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 3","pages":"121-124"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11907156/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649315","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":"Innovative Use of Joshi's External Stabilization System for Tibial Fractures Complicated by Skin and Soft-Tissue Issues: A Case Series.","authors":"Chandrasen Chaugule, Jay Date, Sanket Tanpure, Anjaney Karangutkar, Akash Sonawane, Bhausaheb Jethe","doi":"10.13107/jocr.2025.v15.i03.5386","DOIUrl":"https://doi.org/10.13107/jocr.2025.v15.i03.5386","url":null,"abstract":"<p><strong>Introduction: </strong>Tibia shaft fractures are common orthopedic injuries, and when accompanied by skin complications or with an impending compartment syndrome picture, they present unique challenges in terms of treatment and patient outcomes. Various treatment strategies have been employed for better management of the same. However, external fixation devices are frequently used in orthopedic surgery. Applying a fixator correctly can speed up the healing process while applying it incorrectly will slow it down. This article presents a case series of five patients detailing the successful management of a tibia shaft fracture complicated by skin issues through the application of Joshi's External Stabilization System (JESS) fixator.</p><p><strong>Case report: </strong>We are presenting four cases of tibia fractures with skin problems that may be acute or chronic where it is confusing whether to treat it with internal or external fixation. Patients underwent a single staged external fixation using the JESS with or without debridement, which was followed up for a period of 12 months. In all five cases, we were able to achieve the resolution of skin complications and union of fractures with no reported complications.</p><p><strong>Conclusion: </strong>This outcome of innovative technique guides us through the surgical dilemma with excellent outcomes within a single stage with consolidation of fracture and a resolution of soft-tissue recovery of soft tissues. Thus, it is a reliable option for treating complex tibial fractures with soft-tissue involvement.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 3","pages":"194-199"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11907112/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649335","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":"Total Knee Replacement Versus Osteosynthesis as Primary Treatment in Older Patients with Tibial Plateau Fracture.","authors":"Anna Guillot-Ferriols, Amparo Ortega-Yago, Daniel Bonete-Lluch","doi":"10.13107/jocr.2025.v15.i03.5394","DOIUrl":"https://doi.org/10.13107/jocr.2025.v15.i03.5394","url":null,"abstract":"<p><strong>Introduction: </strong>The treatment of tibial plateau fractures is a challenge in the elderly population due to osteoporosis and associated comorbidities. The choice between open reduction and internal fixation (ORIF) and total knee replacement (TKR) is controversial. The aim of this study is to compare functional outcomes between TKR and ORIF in elderly patients with tibial plateau fractures.</p><p><strong>Materials and methods: </strong>A retrospective observational study was conducted on 27 elderly patients with Schatzker type II, III, or IV tibial plateau fractures treated between January 2018 and December 2022, with prior history of osteoporosis or gonarthrosis. 14 patients underwent treatment with TKR, while 15 patients underwent ORIF. Demographic data, pre-operative characteristics, surgical details, post-operative evolution, and functional outcomes were collected and analyzed.</p><p><strong>Results: </strong>The TKR group consisted mostly of women (92.9%) with a mean age of 76 years, while the ORIF group had a mean age of 68 years. Both groups had similar comorbidity profiles. No significant differences were observed in the mean surgical time (P = 0.18). Significant differences were found between the knee society score (KSS) knee score for total knee arthroplasty (TKA) and ORIF (P = 0.01) and in the KSS function score, with better functional values in the TKA group compared to the ORIF group (P = 0.034). No significant differences were observed in the probability of complications regardless of whether the patients underwent TKA or ORIF (P = 0.6).</p><p><strong>Conclusion: </strong>Treatment of tibial plateau fractures with TKR achieves superior functional outcomes and lower complication rates compared to open reduction and internal fixation in elderly patients.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 3","pages":"220-226"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11907111/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649406","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":"Tubercular Synovitis of Knee presenting with Diabetic Ketoacidosis in a patient with multiple comorbidities.","authors":"Kaunteya Ghosh, Yamini Binani, Prithvi Basu Roy","doi":"10.13107/jocr.2025.v15.i03.5380","DOIUrl":"https://doi.org/10.13107/jocr.2025.v15.i03.5380","url":null,"abstract":"<p><strong>Introduction: </strong>Mono-articular tuberculosis in hip and knee tend to present with late features - articular cartilage destruction, muscle wasting, contractures, and deformity. Comorbidities such as diabetes predispose a patient to infections.</p><p><strong>Purpose: </strong>Herein, we present a case of tuberculosis of the knee with rare presenting features.</p><p><strong>Case report: </strong>A 74-year-old male, previously non-diabetic, presented to our emergency with features of diabetic ketoacidosis. His urine and blood cultures showed no growth. The physiotherapist noted hamstring spasm pain on motion, knee held at 30°, marked effusion (6th day). Purulent 40 cc aspirate was drained. No organism was found (Gram stain, India ink, or AFB) or culture (aerobic, anerobic, and fungal) but aspirate showed marked leukocytosis and raised CRP. USG reported fibrotic lining and the presence of synovial fronds. A history of fatigue, weight loss, and anorexia was elicited. Nodes were impalpable, and the chest was normal. CBNAAT came out negative. The presence of pacemaker implanted 10 years back prevented us from getting a MRI. Biopsy considering diabetes, the procedure was out off. The pulmonologist diagnosed him with smear-negative TB. Anti-tubercular drugs were started.</p><p><strong>Conclusion: </strong>Early detection of tubercular synovitis is based on clinical suspicion and may prevent the development of bony deformity.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 3","pages":"180-184"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11907118/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649410","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":"Biological Stabilization of Proximal Tibiofibular Joint Recurrent Instability with Semitendinosus Graft - Surgical Technique and Case Report.","authors":"Sathish Kumar Thangamani, Sathish Muthu, Sunil P Reddy","doi":"10.13107/jocr.2025.v15.i03.5362","DOIUrl":"https://doi.org/10.13107/jocr.2025.v15.i03.5362","url":null,"abstract":"<p><strong>Introduction: </strong>Proximal tibiofibular joint (PTFJ) instability is an uncommon diagnosis of knee pain and is often misdiagnosed. Anatomical reconstruction has been reported to demonstrate improved outcomes with limited complication rates. While the commonly employed anatomical reconstruction methods involve allografts and free grafts, we report the technique and outcomes of anatomical reconstruction of recurrent PTFJ instability management using semitendinosus autograft.</p><p><strong>Case report: </strong>A 24-year-old young active woman with the instability of the PTFJ underwent stabilization with suspensory loop fixation using a tightrope device along with common peroneal nerve decompression. At 18 months, she reported recurrent instability with episodic knee pain that prevented her sporting activity. She was identified as the failure of the primary stabilization and anatomic biologic reconstruction with semitendinosus was done. The post-operative period was uneventful without any recurrent symptoms the until 1-year follow-up.</p><p><strong>Conclusion: </strong>Non-anatomic reconstruction for PTFJ instability results in late complications like recurrent instability. Semitendinosus can be effectively utilized as the graft of choice for the anatomic reconstruction of the PTFJ ligament complex. Biologic anatomic reconstruction of PTFJ with semitendinosus results in improved clinical outcomes without recurrent complications.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 3","pages":"134-139"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11907128/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649276","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":"Creation of Single-Bone Forearm in Case of Diffuse Chronic Osteomyelitis of Diaphysis of Radius in an Adolescent Treated with Two Staged Procedure: A Case Report.","authors":"Animesh Kumar Singh, Sushant Srivastava, Amresh Kumar, Avanish Kumar, Madhusudan Kumar, Abhishek Arunav","doi":"10.13107/jocr.2025.v15.i03.5328","DOIUrl":"https://doi.org/10.13107/jocr.2025.v15.i03.5328","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic osteomyelitis is a debilitating bone infection that can lead to significant morbidity and functional impairment. This condition is often challenging to treat due to its complex nature and the ability of bacteria to form biofilms, which make them resistant to antibiotics. Early diagnosis and a multidisciplinary approach are crucial for successful management. Orthopedic surgeons often encounter chronic osteomyelitis as a difficult and persistent problem. The key to effective treatment lies in prompt diagnosis and a combination of surgical intervention and antimicrobial therapy. In cases of extensive bone loss or complex infections, a multidisciplinary team, including infectious disease specialists and plastic surgeons, may be necessary to optimize patient outcomes. Isolated involvement of the radius shaft is an uncommon presentation of chronic osteomyelitis.</p><p><strong>Case report: </strong>A 13-year-old male presented with persistent pain, deformity, and multiple draining sinuses on his right forearm. Radiographic imaging confirmed the diagnosis of diffuse chronic osteomyelitis. A two-stage treatment approach was employed to address the infection and restore bone integrity. The first stage involved aggressive debridement of infected tissue, implantation of antibiotic-coated bone cement to deliver sustained drug levels, and stabilization of the fracture using Joshi's External Stabilizing System (JESS). The second stage focused on removing the antibiotic-coated bone cement once the infection was controlled and centralizing the ulna to improve forearm alignment and function.</p><p><strong>Conclusion: </strong>This case highlights the importance of a tailored treatment approach for chronic osteomyelitis. Early intervention, aggressive debridement, appropriate antibiotic therapy, and surgical stabilization are essential components of successful management. In complex cases, a multidisciplinary team can provide optimal care and improve patient outcomes.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 3","pages":"43-47"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11907163/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649296","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":"Evaluation of Functional and Radiological Outcome of Different Cephalomedullary Nail Designs in Intertrochanteric Fractures of Femur.","authors":"Adarsh U Thuppad, Harsh Kirthi Rao, Gaurav C Mendon, Santosha Manjunatha, Suraj M Revankar, Kaveesh P Shetty","doi":"10.13107/jocr.2025.v15.i03.5402","DOIUrl":"https://doi.org/10.13107/jocr.2025.v15.i03.5402","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;The incidence of intertrochanteric (IT) fracture is rising because of increase in the survival of the elderly population with osteoporosis and also the increase in the number of motor vehicle accidents. The treatment of choice is normally surgical with internal fixation. The surgical options for these fractures commonly include fixation with dynamic hip screw (DHS) or cephalomedullary nailing. Due to its advantages over DHS, cephalomedullary nailing is the predominant procedure in many parts of the world. Various varieties of cephalomedullary nails are available. Short cephalomedullary nails are indicated for IT fractures not extending beyond lesser trochanter. There are limited studies on the comparison of short cephalomedullary nails for IT fracture. In this study, we are evaluating functional outcome, radiological union and complications of inter-trochanteric fractures of femur treated with three different short cephalomedullary nails: (1) Proximal femoral nail (PFN)-standard, (2) modified short PFN (MS-PFN) and (3) PFN-A2 of 240 mm.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&gt;Our study is a randomized control trial. Subjects are patients with IT fracture presenting to Srinivas Institute of Medical Sciences and Research Centre. After obtaining informed and written consent, as per inclusion and exclusion criteria, subjects are randomized into three groups (simple randomization) and treated with standard PFN (240 mm length), MS-PFN (180 mm length), and PFN-A2 of length 240 mm as per randomisation. Duration of the surgery and total intraoperative blood loss is noted. Patients are followed up till 1-year post-operative period, in different intervals. Functional outcome using Harris hip score, fracture union, complications are assessed and compared. Considering the lost to follow-up, the final study size obtained is 75 (25 in each group).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;In our study, the average age of the patients is 71.29 years with male predominance and right-side predominance. Majority of the fractures belong to Type 1 Group 2 and type 1 Group 4 of Evan's classification. The average operating time and average intraoperative blood loss is less in PFN-A2 group compared to PFN and MS-PFN groups. The fracture union time is earlier in PFN A2 group compared to PFN and MS-PFN group. Functional outcome is better in PFN-A2 group compared to PFN and MS-PFN groups. In PFN group and PFN A2 of 240 mm length group, there were significant patients with anterior thigh pain. Among 75 patients, 3 in PFN group, 2 in MS-PFN group, and 1 in PFN-A2 group had &gt;1 cm of shortening. 2 patients in PFN group and 1 in MS-PFN group had complication of screw cut-out; 2 in PFN group and 2 in PFN-A2 group had surgical site infection; 1 in PFN group and 1 in PFN-A2 group had varus collapse; and 1 in PFN group and 2 in MS-PFN group had Z effect/reverse Z effect.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;In our study, on comparing three short nails - ","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 3","pages":"244-249"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11907113/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649309","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":"Full Endoscopic Resection of Giant Synovial Cyst in the Lumbar Spine: A Case Report.","authors":"Youssef Jamaleddine, Wendy Ghanem, Ramzi Moucharafieh, Daniel Faddoul, Mohammad Badra","doi":"10.13107/jocr.2025.v15.i03.5330","DOIUrl":"https://doi.org/10.13107/jocr.2025.v15.i03.5330","url":null,"abstract":"<p><strong>Introduction: </strong>Synovial cysts of the lumbar spine are rare pathologies that can cause significant nerve root compression. Traditional surgical treatments often involve open laminectomy with medial facetectomy, which often lead to instability requiring fusion and instrumentation. We present a case of a giant synovial cyst at the L4-L5 level successfully treated using full endoscopic inter-laminar approach.</p><p><strong>Case report: </strong>A 69-year-old male presented with chronic low back pain and left leg radiculopathy. Imaging revealed a giant synovial cyst at L4-L5 level causing severe significant nerve root compression. The patient underwent a full endoscopic inter-laminar approach for total excision of the cyst. Postoperatively, the patient's symptoms resolved, without cyst recurrence or instability at 1 year.</p><p><strong>Conclusion: </strong>Endoscopic total excision of giant synovial cysts is a surgical option that can effectively address symptoms while minimizing the risk of segmental instability. This case demonstrates the feasibility and benefits of this minimally invasive approach.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 3","pages":"48-52"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11907119/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649316","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":"G - Hercnan Syndrome (Giant Hand Extraesqueletal Regular Chondroma No Ollier and No Malignant): Report of a Case and Literature Review.","authors":"Andrés Felipe Varela, Eduardo Velásquez-Girón, Daniel Felipe Kafury, Laura Valeria Muñoz, Jorge Hernández Guevara","doi":"10.13107/jocr.2025.v15.i03.5360","DOIUrl":"https://doi.org/10.13107/jocr.2025.v15.i03.5360","url":null,"abstract":"<p><strong>Introduction: </strong>Extra skeletal chondromas are a subtype of chondroma that constitutes approximately 1.5% of soft tissue tumors; they do not affect the periosteum, cortex, or synovial tissue. They are frequently found in hands and are generally smaller than 3 cm in diameter; few cases are reported larger than 10 cm in diameter.</p><p><strong>Case report: </strong>A 59-year-old female patient with a history of tumor of 12 cm in diameter in the interdigital region between the first and second of the left hand of 9 years of evolution with involvement of the thumb opposition, with magnetic resonance imaging findings with isointensity in T1 and hyperintensity in T2, without enhancement to gadolinium, She is taken to an excisional biopsy where there is evidence of adherence to the sensory branch of the median nerve, with report of extra skeletal chondroma pathology, with follow-up 1 year post-surgery with total recovery of functionality without evidence of recurrence, additionally tumor with clinical and imaging suggestive of enchondroma in the fifth finger of the left hand and in the frontal region.</p><p><strong>Conclusions: </strong>We present an unusual clinical case of extra skeletal chondroma of 12 cm in diameter with compromised mobility of the first finger and adherence to the sensory branch of the median nerve, accompanied by suggestive enchondromas in the fifth finger of the same hand and frontal region, without pathological findings of Ollier's disease, malignancy, or recurrence at 1 year of follow-up. We intend to highlight the importance and magnitude, to which extraskeletal chondromas can reach, without being considered benign tumors, they can have important effects due to their mechanical compression.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 3","pages":"130-133"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11907141/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649325","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":"Charcot Spinal Arthropathy Secondary to Spinal Cord Injury - A Case Report.","authors":"Jeff J Cherian, Jacqueline C Ma, Fanny E Morón, Chitra Viswanathan","doi":"10.13107/jocr.2025.v15.i03.5364","DOIUrl":"https://doi.org/10.13107/jocr.2025.v15.i03.5364","url":null,"abstract":"<p><strong>Introduction: </strong>Charcot spinal neuroarthropathy is a progressive destructive vertebral disease characterized by a loss of pain sensation and proprioception. Diagnosing this condition is particularly challenging because symptoms can appear at widely varying times and the neurological symptoms and imaging findings are non-specific. In contemporary cases, Charcot spine is often associated with chronic traumatic spinal cord injuries, in which the lack of proper sensation can hide the early signs of discovertebral destruction, making it even more difficult to promptly diagnose and treat.</p><p><strong>Case report: </strong>A 47-year-old female with a history of American Spinal Injury Association Grade A spinal cord injury presented with dysreflexia, postural changes, and imaging findings consistent with Charcot spine at the T11-T12 level. The patient underwent a successful posterior instrumented spinal fusion. Two years later, the patient presented with worsening pain and dysreflexia and was consequently diagnosed with a second Charcot spine at the L3-L4 level requiring an L3-pelvis fixation.</p><p><strong>Conclusion: </strong>Charcot spinal arthropathy is a complex diagnosis of exclusion based on history and histopathologic and radiologic findings. This case adds to a very limited number of reports exploring the long-term outcomes of surgical management in Charcot spine and highlights the need for examining the relationship between surgical fusion and acceleration of vertebral joint destruction in hopes to help establish future management guidelines.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 3","pages":"140-145"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11907159/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649280","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}