Journal of Orthopaedic Case Reports最新文献

{"title":"Biplane Fractures of the Distal Femur: A Proposed Computed Tomography-Based Classification and Surgical Management.","authors":"Mohammed Sadiq, Sharon Rose Neerudi, Rohith Reddy Kasam, Kothalanka Udaya Kumar, Koribilli Sai Pradeep, Anudeep Manne","doi":"10.13107/jocr.2026.v16.i10.8358","DOIUrl":"10.13107/jocr.2026.v16.i10.8358","url":null,"abstract":"<p><strong>Introduction: </strong>Management of periarticular fractures requires a careful understanding of fracture characteristics and proper pre-operative planning. We suggest a new computerized tomography (CT) based classification system, which assists in planning surgical approaches and in implant selection, and provides an addition to the metaphyseal comminution along with the articular type.</p><p><strong>Materials and methods: </strong>50 patients with biplanar distal articular fractures were included in our study and were classified using the CT-based classification. The CT images and intra-operative photographs were reviewed by five independent orthopedic surgeons and one radiologist to assess the reliability of the classification system. Postoperatively, patients were followed up at regular intervals, and range of motion and the Knee Society Score were assessed at 6 months.</p><p><strong>Discussion: </strong>AO Muller's classification gives a good idea of metaphyseal and intra-articular involvement, which is followed worldwide for plan of management and fixation. This is based on 2D images. The classification described here is based on CT imaging, in which the 3D configuration has subtypes based on fracture fragments involving both intra-articular and extra- articular, which helps in understanding the fracture configuration in 3D and also helps in fixation of the fracture.</p><p><strong>Results: </strong>According to our proposed CT-based classification, distal femur fractures are classified as uniplanar (A and B) and biplanar types (C, D, E, and F). Among the biplanar fractures, the severity of articular comminution increases from type C to type F. We found that among the biplanar fractures, Type D (three-part fracture) was the most common fracture type. We found that Type C fractures had the best outcome, whereas type F had the worst functional results.</p><p><strong>Conclusion: </strong>This CT-based classification system can assess the severity of the articular comminution, decide the surgical approach and implant selection, and grade the prognosis.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"16 10","pages":"635-641"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13646815/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149137052","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":"Efficacy of Intra-Articular Injection of Platelet-Rich Plasma and Growth Factor Concentrate in Degenerative Meniscal Lesions.","authors":"Sandeep Bishnoi, Siddharth Jain, Amit Saraf, Seema Awasthi, Rajul Rastogi, S Krishna Kumar","doi":"10.13107/jocr.2026.v16.i10.8328","DOIUrl":"10.13107/jocr.2026.v16.i10.8328","url":null,"abstract":"<p><strong>Introduction: </strong>Degenerative meniscal lesions are common in early knee osteoarthritis (OA) and represent a principal structural cause of pain and functional impairment. Conventional treatments offer palliative relief without retarding structural deterioration. Intra-articular orthobiologics - platelet-rich plasma (PRP) and growth factor concentrate (GFC) - have gained prominence as restorative therapies. This randomized controlled trial aimed to evaluate and compare the clinical and radiological efficacy of intra-articular PRP versus GFC injections in patients with degenerative meniscal lesions in Kellgren-Lawrence (K-L) Grade I and II knee OA.</p><p><strong>Materials and methods: </strong>Fifty-four patients aged 41-78 years presenting with symptomatic K-L Grade I/II knee OA and magnetic resonance imaging (MRI)-confirmed degenerative meniscal tears were randomized into three parallel groups (n = 18/group): Group A (PRP), Group B (GFC), and Group C (Normal Saline control). All patients received two injections spaced 4 weeks apart. Clinical pain and functional disability were assessed using Visual Analog Scale (VAS) and Western Ontario and McMaster Universities OA Index (WOMAC) at baseline, 1, 3, 6, and 9 months. Radiological meniscal integrity was quantified through whole-organ MRI score (WORMS) at baseline and 9 months.</p><p><strong>Results: </strong>At baseline, demographic and clinical scores were comparable across all three arms (P > 0.05). At 9-month follow-up, the GFC group demonstrated the greatest clinical improvement, with VAS pain scores reducing by 42.35% (from 6.21 ± 0.71 to 3.58 ± 0.74), significantly outperforming the PRP group (19.27% reduction, from 6.33 ± 0.69 to 5.11 ± 0.77) and the control group (+17.67% deterioration; P < 0.0001). WOMAC functional scores decreased by 32.44% in the GFC group (59.16 ± 8.26-39.97 ± 6.21) versus 20.56% in the PRP group (59.58 ± 8.72-47.33 ± 7.05) and +8.53% worsening in controls (P < 0.0001). Structural evaluation through WORMS revealed marked improvement in both active arms (GFC: -42.25%; PRP: -40.22%) compared to control (-2.25%; P < 0.0001), with no significant difference between GFC and PRP.</p><p><strong>Conclusion: </strong>Intra-articular GFC achieves superior analgesic and functional outcomes compared to PRP in early degenerative meniscal disease. Both biologic therapies promote comparable structural stabilization and reduction of joint effusion on MRI. GFC represents a potent, acellular, minimally invasive orthobiologic option for joint preservation.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"16 10","pages":"508-514"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13646794/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149136664","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":"Functional Outcome of Retrograde Femoral Nailing Versus Minimally Invasive Percutaneous Plate Osteosynthesis in Extra-Articular Distal Femur Fractures: A Prospective Quasi-Randomized Comparative Study.","authors":"Neeraj Singla, Anshul Dahuja, Lovish Gulbadhar, Kapil Bansal, Krishmveer Singh, Manmohan Singh","doi":"10.13107/jocr.2026.v16.i10.8298","DOIUrl":"10.13107/jocr.2026.v16.i10.8298","url":null,"abstract":"<p><strong>Introduction: </strong>Distal femur fractures represent a challenging injury due to their proximity to the knee joint and the need to restore limb alignment and function. Surgical management has evolved with techniques such as retrograde femoral nailing (RFN) and minimally invasive percutaneous plate osteosynthesis (MIPPO). Both techniques aim to achieve stable fixation while preserving soft tissue and vascularity. We performed an analysis on both groups (30 patients each), and our primary objectives compared were radiological union time, weight-bearing, and functional outcome using NEER's score. Our secondary objectives were complications, surgical time, and fluoroscopy exposure.</p><p><strong>Materials and methods: </strong>This prospective comparative study included 60 patients with extra-articular distal femur fractures treated at a tertiary care center. Patients were divided into two groups using an alternate allocation method: (1) Group A: RFN (n = 30). (2) Group B: MIPPO with locking plate (n = 30).</p><p><strong>Results: </strong>Patients treated with RFN demonstrated earlier initiation of partial and full weight-bearing and earlier fracture union compared with the MIPPO group. Functional outcomes assessed by NEER's score were better in the RFN group at 6 weeks and 3 months, while both groups showed comparable results by 6 months follow-up. Complications observed included superficial infection, knee stiffness, malunion, and non-union.</p><p><strong>Conclusion: </strong>Both RFN and MIPPO are effective methods for treating extra-articular distal femur fractures. RFN allows earlier mobilization and functional recovery, while MIPPO preserves fracture biology and soft-tissue integrity. The choice of technique should be individualized based on fracture pattern, patient factors, and surgeon experience. Larger multicenter trials with longer follow-up are needed to confirm these findings.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"16 10","pages":"392-399"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13646554/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149136829","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 Solitary Large Calcaneal Osteochondroma in a Skeletally Mature Patient: Case Report.","authors":"Bismaya Sahoo, Jitendra Kumar, Debraj Bhaumik, Amit Kumar, Mainak Roy, Md Hasanuzzaman","doi":"10.13107/jocr.2026.v16.i10.8204","DOIUrl":"10.13107/jocr.2026.v16.i10.8204","url":null,"abstract":"<p><strong>Introduction: </strong>Calcaneal osteochondromas are rare, particularly in skeletally mature adults where continued growth often raises suspicion for malignant transformation. This case highlights one of the largest benign calcaneal osteochondromas reported in an adult, demonstrating extensive growth after epiphyseal closure without malignant change.</p><p><strong>Case report: </strong>A 38-year-old male presented with an 8-year history of left foot pain and a progressively enlarging plantar mass for 7 years. The mass enlarged over 5 years and stabilized for the last 2 years. Examination revealed a hard, tender, plantolateral swelling with overlying hyperkeratosis. Radiographs showed a large sessile bony mass arising from the plantar calcaneus. En bloc excision was performed. The mass measured 7.5 × 5 × 3 cm with a cartilage cap of 9 mm. Histopathology confirmed benign osteochondroma with no malignant transformation. The patient recovered uneventfully and remained recurrence-free at 24 months.</p><p><strong>Conclusion: </strong>Large calcaneal osteochondromas can present in adulthood and may grow after skeletal maturity without malignant change. Surgical excision provides excellent outcomes with negligible recurrence when margins are adequate.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"16 10","pages":"106-112"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13646454/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149136656","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":"Congenital Asymmetrical Multiple Limb Deficiency in 1-Year-Old Male Child: A Case Report.","authors":"Rohit Shukla, Ankita Dubey, Rupendra Sahu, Vibhor Jain","doi":"10.13107/jocr.2026.v16.i10.8208","DOIUrl":"10.13107/jocr.2026.v16.i10.8208","url":null,"abstract":"<p><strong>Introduction: </strong>Congenital limb deficiency is an uncommon musculoskeletal anomaly that may occur as an isolated defect or as part of a syndrome. It can present as transverse or longitudinal deficiency and may involve one or multiple limbs.</p><p><strong>Case report: </strong>A 1-year-old male child was brought to the outpatient department with congenital deficiencies involving both upper and lower limbs. He was the third child of non-consanguineous parents, born at full term by normal vaginal delivery with assistance from a local birth attendant. Antenatal care was inadequate, with only two antenatal visits and one ultrasonographic examination. Clinical examination revealed asymmetrical multiple limb deficiencies affecting all four limbs, associated with right foot syndactyly and lower dorsal scoliosis. Radiographs confirmed a combination of transverse and longitudinal limb deficiencies.</p><p><strong>Conclusion: </strong>This case describes a rare presentation of congenital asymmetrical multiple limb deficiency involving all four limbs, with mixed transverse and longitudinal deficiencies. This case highlights the importance of antenatal checkup and anomaly scans in the early diagnosis and counseling of congenital anomalies.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"16 10","pages":"120-123"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13646463/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149137069","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":"Posterior Hip Dislocation with Ipsilateral Subtrochanteric Femur Fracture: A Rare Case Report.","authors":"Amrit Goyal, Vishal Kumar Lakhera, Sudhanshu Agarwal","doi":"10.13107/jocr.2026.v16.i10.8210","DOIUrl":"10.13107/jocr.2026.v16.i10.8210","url":null,"abstract":"<p><strong>Introduction: </strong>Posterior dislocation of the hip associated with an ipsilateral subtrochanteric femur fracture is a rare and technically challenging injury pattern, most commonly seen after high-energy trauma such as road traffic accidents. The associated proximal femoral fracture disrupts the normal femoral lever arm, making closed reduction difficult or impossible and often necessitating open reduction. Delay in diagnosis or treatment may result in complications such as avascular necrosis of the femoral head, post-traumatic arthritis, sciatic nerve injury, and poor functional outcomes.</p><p><strong>Case report: </strong>We report the case of a 35-year-old male who sustained posterior hip dislocation with an ipsilateral subtrochanteric femur fracture following a road traffic accident. The patient presented with pain, deformity, and inability to bear weight on the affected limb. As he was hemodynamically unstable at presentation, definitive surgery was delayed until adequate resuscitation and stabilization were achieved. Surgery was performed within 72 h and included open reduction of the hip through a posterior approach using a Steinmann pin as a joystick for reduction, followed by fixation of the subtrochanteric fracture using a proximal femoral nail (PFN). At 15 days follow-up, the wound had healed well, implant position was satisfactory, and no early post-operative complications were noted.</p><p><strong>Conclusion: </strong>Posterior hip dislocation with ipsilateral subtrochanteric femur fracture is an uncommon injury that requires early diagnosis, careful surgical planning, and stable fixation. Open reduction is often necessary because closed reduction may not be feasible due to loss of the proximal femoral lever arm. Joystick-assisted reduction with a Steinmann pin and fixation with PFN can provide satisfactory early outcomes. Long-term follow-up remains essential to monitor for complications such as avascular necrosis and post-traumatic arthritis.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"16 10","pages":"124-128"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13646461/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149137229","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":"Clinicopathological Spectrum and Management of Aneurysmal Bone Cysts in Atypical Anatomical Location: A Comprehensive Review of Demographics, Presentation, Diagnosis, and Treatment Outcomes.","authors":"Purushotham Lingaiah, Showry Abraham, Bache Manmohan Sai, Rambabu Lavudi, Sabaricharan Shanmugham, Mikhael Uthup","doi":"10.13107/jocr.2026.v16.i10.8344","DOIUrl":"10.13107/jocr.2026.v16.i10.8344","url":null,"abstract":"<p><strong>Introduction: </strong>Aneurysmal bone cysts (ABCs) are benign but locally aggressive osteolytic lesions characterized by blood-filled cystic spaces separated by fibrous septa containing osteoclast-like giant cells and reactive bone. Although commonly affecting the metaphysis of long bones in children and adolescents, ABCs may occur in atypical anatomical locations, creating diagnostic and therapeutic challenges. The aim of this study was to review the demographic characteristics, clinical presentation, radiological and histopathological features, diagnostic challenges, and current management strategies of atypically presenting ABCs.</p><p><strong>Materials and methods: </strong>A narrative review was performed using articles published in the Journal of Orthopaedic Case Reports from 2011 to 2026. Forty-two records were initially identified (41 case reports and 1 case series); 15 were excluded after initial screening, and 10 additional reports were excluded at full-text assessment because they described conventional metaphyseal ABCs, leaving 17 reports (16 case reports and 1 case series) for the atypical-location review. Because this was a narrative review restricted to a single journal, no pooled effect estimates or formal comparative treatment conclusions were attempted.</p><p><strong>Results: </strong>ABCs predominantly occur during the first two decades of life and commonly involve the distal femur, proximal tibia, proximal humerus, and spine. Pain and swelling are the most frequent presenting symptoms. Radiographs typically demonstrate expansile osteolytic lesions with a multiloculated appearance, while magnetic resonance imaging frequently reveals fluid-fluid levels. Histologically, lesions consist of blood-filled spaces, fibroblastic septa, osteoclast-like giant cells, and reactive woven bone. Management options include curettage with bone grafting, sclerotherapy, en bloc resection, and reconstruction depending on lesion location and aggressiveness. Recurrence rates vary between 10% and 30%, with lower recurrence following complete excision.</p><p><strong>Conclusion: </strong>ABCs exhibit a wide clinicopathological spectrum. In atypical anatomical locations, diagnosis requires careful clinicoradiological correlation and histopathological confirmation. Management should be individualized according to lesion biology, anatomical constraints, skeletal maturity, and functional requirements; however, treatment effectiveness and recurrence rates cannot be established reliably from the predominantly case-report-based evidence reviewed here.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"16 10","pages":"571-579"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13646818/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149137101","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":"Osteogenic Potential of Bone Callus: A Cross-sectional Study on Microscopic Structure and Healing Stages.","authors":"Sundip Hemant Charmode, Abhishek Kumar Mishra, Simmi Mehra","doi":"10.13107/jocr.2026.v16.i10.8314","DOIUrl":"10.13107/jocr.2026.v16.i10.8314","url":null,"abstract":"<p><strong>Introduction: </strong>Bone callus formation is a critical phase of post-fracture osseous regeneration. Despite extensive animal-model research, human histological data characterizing the osteogenic and osteoconductive microstructure of bone callus across different age groups and genders remain sparse. This study aimed to evaluate the microscopic structure of bone callus with a focus on osteoblast density and osteoconductive parameters in fracture patients at a tertiary care center.</p><p><strong>Materials and methods: </strong>This cross-sectional observational pilot study analyzed bone callus samples from 10 of 23 recruited fracture patients (≥18 years) who underwent open reduction and internal fixation at All India Institute of Medical Sciences, Rajkot. Samples were collected intraoperatively, processed, and stained with hematoxylin and eosin. Five osteoconductive variables - osteoblast density, trabecular thickness, trabecular spacing, trabecular number, and bone volume fraction - were quantified using Image analysis software (NIH, USA) and compared across gender and two age groups (15-24 years vs. 25-64 years). An adult carpal bone (lunate) served as a control. Statistical comparison used the unpaired Student's t-test (Statistical Package for the Social Sciences v16.0).</p><p><strong>Results: </strong>Male callus exhibited higher osteoblast density (426.7 ± 19.0 vs. 402.5 ± 23.1 N/mm2) and bone volume fraction (54.6 ± 3.0% vs. 51.5 ± 2.7%) than female samples, though not statistically significant (P > 0.05). The younger age group (15-24 years) demonstrated higher osteoblast density (431.3 ± 8.5 N/mm2), trabecular thickness (0.49 ± 0.03 mm), trabecular number (1.74 ± 0.06 N/mm), and bone volume fraction (57.3 ± 2.5%) than the middle-aged group (25-64 years), without reaching statistical significance (P > 0.05). Both callus groups showed higher osteoconductive parameters compared to the adult control bone (lunate).</p><p><strong>Conclusion: </strong>Bone callus in younger individuals showed numerically higher osteogenic microstructural parameters than middle-aged counterparts, although these pilot-phase differences did not reach statistical significance in this small cohort (n = 10), and all callus samples showed greater osteoblast activity than mature adult bone. These preliminary histological findings suggest - but do not establish - a potential role for bone callus as an autograft material; confirmation of its osteogenic/osteoconductive efficacy will require larger confirmatory cohorts and immunohistochemical, micro-computed tomography, and clinical/experimental validation in the continuation phase of the study.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"16 10","pages":"455-463"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13646810/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149137245","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 Primary Definitive Internal Fixation of Compound Fractures within 72 h of Injury: A Prospective Cohort Study.","authors":"Sayam Ghosh, Pranay C Choudhary, Ramaraju M P Mudunuri","doi":"10.13107/jocr.2026.v16.i10.8290","DOIUrl":"10.13107/jocr.2026.v16.i10.8290","url":null,"abstract":"<p><strong>Introduction: </strong>Open (compound) fractures carry a high risk of infection and delayed healing. Early definitive internal fixation within 72 h, guided by objective injury-severity scoring, has emerged as an alternative to traditional staged fixation. This study aimed to evaluate the outcomes of primary definitive internal fixation performed within 72 h of injury in patients with compound fractures selected using the Ganga Hospital Open Injury Score (GHOIS ≤9).</p><p><strong>Materials and methods: </strong>This prospective cohort study was conducted in a tertiary-care orthopedic center in India between March 2023 and November 2024, and included 140 patients with compound fractures (GHOIS ≤9) who underwent debridement and early definitive internal fixation within 72 h of injury under a standardized antibiotic protocol. Patients were followed for 1 year; outcomes assessed included fracture union, soft-tissue healing, functional outcome (modified Ketenjian and Sheldon criteria), hospital stay, and complications.</p><p><strong>Results: </strong>Mean patient age was 37.08 years, with male predominance (60.71%). Road traffic accidents were the most common mechanism of injury (81.42%). Gustilo-Anderson Type IIIA fractures were most frequent (40%), and the mean GHOIS was 7.25. Mean time since injury was 3.82 h and mean time to definitive fixation was 45.8 h. Intramedullary nailing was the most common fixation method (54.28%). Soft-tissue coverage was not required in 47.14% of cases; primary split-skin grafting was used in 35.71%. Functional outcome was excellent or good in 64.28% of patients. Mean soft-tissue healing time was 3.75 weeks, mean time to union was 28.49 weeks, and mean hospital stay was 11.59 days. Infection (11.42%) was the most common complication, followed by stiffness and non-union (4.28% each) and delayed union (0.71%).</p><p><strong>Conclusion: </strong>Primary definitive internal fixation of compound fractures within 72 h of injury, in appropriately selected patients with GHOIS ≤9, was associated with favorable functional outcomes, acceptable union and healing times, and a manageable complication profile. These findings support the feasibility of early definitive fixation in selected open tibial fractures; however, comparative studies are required to determine whether this approach offers advantages over staged fixation.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"16 10","pages":"361-367"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13646555/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149136702","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":"Translating and Validating a Hindi Version of the Spine Functional Index: Cross-cultural Adaptation and Psychometric Testing in an Indian Orthopedic Population.","authors":"Sharath Raj, Deepak Kumar, Vishal Kumar, Ajay Jose, Saloni Rani Kumar, Vijay G Goni","doi":"10.13107/jocr.2026.v16.i10.8304","DOIUrl":"10.13107/jocr.2026.v16.i10.8304","url":null,"abstract":"<p><strong>Introduction: </strong>Existing Hindi patient-reported measures for spinal disorders assess the cervical and lumbar spine separately. The spine functional index (SFI) evaluates whole-spine functional limitation using 25 items, with validated Spanish, Turkish, and Chinese versions, but not Hindi. This study aimed to translate and culturally adapt the SFI into Hindi (SFI-Hi) and evaluate its measurement properties, including responsiveness and the minimal clinically important difference (MCID), in Indian patients with spinal disorders.</p><p><strong>Materials and methods: </strong>The SFI was translated and culturally adapted using forward-backward translation, expert review, and pilot testing. One hundred eighty-six consecutive adults with chronic (≥12 weeks) cervical, lumbar, or combined spinal disorders completed the SFI-Hi, Hindi functional rating index (FRI-Hi), Hindi SF-12, and a pain visual analog scale (VAS); cervical patients also completed the Hindi neck disability index (NDI-Hi), and lumbar patients the Hindi Oswestry disability index (ODI-Hi). Ninety stable participants repeated the SFI-Hi after 5-7 days, and 92 treated patients were reassessed at 6 weeks for responsiveness and MCID. Internal consistency, test-retest reliability, measurement error, construct validity, principal component analysis (PCA), responsiveness, MCID, and floor/ceiling effects were assessed.</p><p><strong>Result: </strong>Mean SFI-Hi score was 49.0 ± 16.6 on a 0-100 disability scale. Internal consistency was high (Cronbach's α = 0.92), and test-retest reliability was excellent (ICC2,1 = 0.96, 95% CI 0.94-0.98), with a standard error of measurement of 2.8% and minimal detectable change of 6.5%. PCA identified a single dominant component explaining 35.0% of variance. Correlations were observed with the ODI-Hi (r = 0.64), FRI-Hi (r = 0.56), NDI-Hi (r = 0.53), VAS (r = 0.46), and SF-12 physical functioning (r = -0.54); only three of six prespecified hypotheses were confirmed. The SFI-Hi demonstrated good responsiveness (standardized response mean 0.84), with a 13.2-point improvement at 6 weeks (P < 0.001); the anchor-based MCID was 8 points (AUC 0.81). No clinically important floor or ceiling effect was observed. I was observed.</p><p><strong>Conclusion: </strong>The SFI-Hi demonstrated high internal consistency, excellent test-retest reliability, good responsiveness, and a predominantly unidimensional structure in this Indian cohort, with partial support for construct validity. It is a promising whole-spine outcome measure for Hindi-speaking patients, warranting further evaluation in larger, more diverse populations.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"16 10","pages":"415-422"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13646537/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149137342","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}