Journal of Orthopaedic Case Reports最新文献

{"title":"Functional and Radiological Outcomes after Locking Plate Fixation of AO Type 33C Distal Femur Fractures.","authors":"Ayush Prakash, Sanjay Kumar, Rohit Nath, Sanavvar Ali","doi":"10.13107/jocr.2025.v15.i02.5306","DOIUrl":"10.13107/jocr.2025.v15.i02.5306","url":null,"abstract":"<p><strong>Introduction: </strong>Treatment of supracondylar and intercondylar fractures of the distal femur has historically been difficult. These fractures are often unstable and comminuted and tend to occur in the elderly or in patients with multiple injuries.</p><p><strong>Objective: </strong>The purpose of the study is to assess the functional and radiological outcome of locking plate fixation in AO type 33C distal femur fractures.</p><p><strong>Materials and methods: </strong>A total of 49 patients with distal femoral fractures were operated by open reduction with internal fixation with a distal femur-locking compression plate (LCP) through the standard swashbuckler approach. The functional and radiological outcomes were assessed using the Neers scoring system.</p><p><strong>Results: </strong>Out of 49 patients, Muller type C2 was the most common fracture with 36 out of 49 (73.5%). Union was found in 47 patients with two patients presenting with non-union. The average union time of the fracture was 12-20 weeks with the mean time of union being 16.2 weeks. All patients were successfully given a walking aid in the 20th week. The average knee score was 79.71 using the Neers scoring system.</p><p><strong>Conclusion: </strong>Fractures of the distal femur are more common in high-velocity injuries and occur in middle-aged males and old age women. Most fractures were comminuted. LCP appears to be technically an ideal implant for comminuted distal femoral fractures with proper physiotherapy producing excellent results. Knee stiffness was the most common complication.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 2","pages":"275-282"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11823845/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433181","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":"Granulomatous Tenosynovitis of the Volar Wrist from Mycobacterium Avium Complex - A Case Report.","authors":"Eric Taris, Christopher Guerra, Parth A Goenka, Jeffrey A Marchessault","doi":"10.13107/jocr.2025.v15.i02.5256","DOIUrl":"10.13107/jocr.2025.v15.i02.5256","url":null,"abstract":"<p><strong>Introduction: </strong>Mycobacterium avium complex (MAC) musculoskeletal (MSK) involvement is a rare clinical presentation of the upper extremity. When MSK involvement does occur, hand and wrist involvement are the most often reported due to the rich synovial fluid environment in these regions. This report describes an unusual case of tenosynovitis of the hand, in which a patient presented with a prolonged course of wrist pain due to MAC.</p><p><strong>Case report: </strong>An 87-year-old Caucasian, right-handed female presented with a 2-year history of right wrist pain and swelling. There had been no previous trauma or immunocompromised state. The patient was hospitalized for severe pneumonia 2 years ago, with wrist pain developing in the months after discharge. The treatment course included radical synovectomy and subsequent triple antibiotic therapy upon confirmation of MAC rice bodies. Due to advanced age and worsening dementia, the patient did not follow-up until 2 years post-operatively. Upon return at 2 years postoperatively, the patient had concerns of recurrent tenosynovitis. Treatment was declined by the family at this time and the patient did not return again until 5 years postoperatively with continued worsening tenosynovitis. Repeat synovectomy was suggested; however, additional treatment was held by the family due to the patient's cognitive decline.</p><p><strong>Conclusion: </strong>The aim of this report is to describe an atypical presentation of MAC-induced tenosynovitis. Patients diagnosed with a MAC infection should be treated promptly and informed of the possibility of recurrence. The goal of this report is to encourage practitioners to keep MAC infection on their list of differentials when evaluating abnormal wrist swelling.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 2","pages":"131-135"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11823880/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433184","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":"Clay-shoveler's Fracture in a 13-year-old Child - Case Report and Review of Literature.","authors":"Panagiotis Antzoulas, Savvas Giakoumakis, Ioannis Sperelakis, Vasileios Giannatos, Andreas Panagopoulos","doi":"10.13107/jocr.2025.v15.i02.5248","DOIUrl":"10.13107/jocr.2025.v15.i02.5248","url":null,"abstract":"<p><strong>Introduction: </strong>A clay-shoveler's fracture is a relatively uncommon stress-type avulsion fracture typically affecting the lower cervical or upper thoracic spinous processes. Historically named after clay shovelers due to their predisposition to such injuries, this type of fracture is now more frequently observed in individuals participating in sports activities that entail rotational movements of the upper spine.</p><p><strong>Case report: </strong>A 13-year-old patient, while performing agricultural work and using a manual shovel to excavate an area, experienced cramping in the cervical spine, neck pain, and a significant limitation in the range of motion. The patient presented with a history and physical examination suggestive of a clay-shoveler's fracture. Subsequent X-ray images demonstrated an acute soft-tissue avulsion of the spinous process at C7. With non-operative therapy, the patient returned to work within 2 months, experiencing occasional, intermittent discomfort 6 months after the injury, which did not limit any activities. After 2 years of follow-up, the patient reported no pain.</p><p><strong>Conclusion: </strong>A clay-shoveler's fracture is a rare stress-type avulsion fracture, particularly in children. Diagnosis necessitates clinical suspicion, a targeted history, and a thorough physical examination. Radiographs play a crucial role, and in challenging cases, magnetic resonance imaging may be warranted to detect soft-tissue avulsions. Treatment typically involves cervical immobilization of the cervical spine for 4-6 weeks.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 2","pages":"111-115"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11823846/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433295","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":"Musculoskeletal Manifestations of Rare Lymphoproliferative Neoplasms: A Retrospective Case Report of Four Cases.","authors":"Meagan E Tibbo, Max C Baron, Alina Syros, Jacob Cohen, H Thomas Temple, Brooke Crawford","doi":"10.13107/jocr.2025.v15.i02.5286","DOIUrl":"10.13107/jocr.2025.v15.i02.5286","url":null,"abstract":"<p><strong>Introduction: </strong>Lymphoproliferative neoplasms (LPNs) can lead to diverse musculoskeletal manifestations, presenting diagnostic challenges due to their rarity and atypical clinical features.</p><p><strong>Case report: </strong>This retrospective case series, conducted at a tertiary care hospital, examines four patients with rare LPNs - Rosai-Dorfman disease, Kimura disease, and Castleman disease - initially misdiagnosed as nonneoplastic conditions. The study aims to underscore the importance of histopathological evaluation in achieving accurate diagnoses and initiating timely management. Results reveal diagnostic complexities, with an average of 2.5 biopsies required for accurate diagnosis.</p><p><strong>Conclusions: </strong>In-depth case discussions highlight the unique challenges and treatment strategies for each LPN. The central theme emphasizes the critical role of histopathology in distinguishing these rare LPNs from more common musculoskeletal disorders, guiding appropriate therapeutic interventions, and optimizing patient outcomes. These cases serve as poignant examples of the diagnostic pitfalls encountered by clinicians when faced with rare LPNs, reinforcing the necessity of a nuanced approach and collaboration between clinicians and pathologists in achieving accurate diagnoses.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 2","pages":"209-214"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11823876/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433378","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":"Primary Pyogenic Abscess in an Immunocompetent Child: An Indian Perspective.","authors":"Swapnil Keny, Harsh Parekh, Janki Chaudhary, Nikhil Gokhale, Nihar Modi","doi":"10.13107/jocr.2025.v15.i02.5274","DOIUrl":"10.13107/jocr.2025.v15.i02.5274","url":null,"abstract":"<p><strong>Introduction: </strong>Pyogenic psoas abscess (PPA) is a rare but severe condition. Previously linked to tuberculosis, it's now seen with diverse causes. This case report details the diagnosis and management of PPA in a healthy Indian child, initially suspected of having hip issues.</p><p><strong>Case report: </strong>A 5-year-old girl was brought for pain in her right hip and lower back, and fever for 3 days. She was irritable and unable to walk. She was febrile (101°F), irritable, and toxic with her right lower limb flexed 30° at the hip with all its movements restricted and painful. Inguinal lymph nodes were palpable. Blood tests showed elevated white blood cell count (18,000 × 109/L) and inflammatory markers, with a negative Mantoux test. Radiographs of the lumbosacral spine were normal. Magnetic resonance imaging showed a large abscess in the right psoas and iliacus muscles, measuring 6.8 × 3.3 × 3 cm. She underwent open drainage through a retroperitoneal approach, and samples were sent for bacteriological analysis. The wound was irrigated and closed over a drain.Post-operatively, she received Linezolid being culture positive for methicillin-resistant Staphylococcus aureus. Her pain reduced by the 3rd day and she was discharged with oral antibiotics. She walked at 6 weeks and was symptom-free on follow-up.</p><p><strong>Conclusion: </strong>This case highlights the crucial need to consider PPA in children showing hip pain, limping, and infection signs. Due to its subtle presentation and similarity to septic arthritis, high suspicion is essential. Timely imaging and proper treatment, such as drainage and antibiotics, can ensure positive results.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 2","pages":"177-182"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11823889/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433441","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":"Tuberculosis of Rib: Diagnosis and Treatment.","authors":"Mantu Jain, Shibashis Mohapatra, Sujit Tripathy, Baijayantimala Mishra, K P Lubaib, Ankit Bhagat","doi":"10.13107/jocr.2025.v15.i02.5220","DOIUrl":"10.13107/jocr.2025.v15.i02.5220","url":null,"abstract":"<p><strong>Introduction: </strong>Primary tuberculosis (TB) of a rib is a very uncommon presentation and accounts for <1% of musculoskeletal TB.</p><p><strong>Case report: </strong>This case report studies a 34-year-old immunocompetent individual who presented with dull-aching right-side lower chest wall pain and swelling with constitutional symptoms. A routine X-ray of the chest was performed, which revealed no abnormality. Therefore, magnetic resonance imaging was performed given soft-tissue swelling, which suggested an extra-pulmonary swelling with lytic 9th rib lesion TB. The diagnosis was confirmed using a gene-expert of ultrasound-guided aspirated material. A drug susceptibility test was done, and it was found to be rifampicin sensitive. Hence, the patient was started on anti-tubercular therapy. The patient responded to it remarkably and was symptom-free at the end of 1 year.</p><p><strong>Conclusion: </strong>The case illustrates that a high degree of suspicion, early diagnosis, and timely intervention are the key to management.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 2","pages":"37-41"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11823840/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433476","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":"Deformity Correction and Limb Lengthening in Maffucci Syndrome - A Case Report.","authors":"Amit Kumar Yadav, Sameer Panchal, Sangeet Gawhale, Farokh Wadia","doi":"10.13107/jocr.2025.v15.i02.5226","DOIUrl":"10.13107/jocr.2025.v15.i02.5226","url":null,"abstract":"<p><strong>Introduction: </strong>?Maffucci syndrome (MS) is a rare disorder with enchondromatosis associated with multiple hemangiomas in soft tissue and internal organs. Enchondromas in the long bone lead to limb length discrepancy, deformity, and pathological fractures that usually need corrective osteotomies and limb lengthening.</p><p><strong>Case report: </strong>A female in her late adolescence with MS presented with significant varus deformity of the distal femur and left lower limb shortening of 11.5 cm. She underwent an acute correction of the varus with a distal femur osteotomy and gradual femoral lengthening using a monolateral fixator. She sustained a pathological fracture through the regenerate, needing an intramedullary nail stabilisation during follow-up. At a 2-year follow-up, the patient was left with a residual shortening of 5 cm, corrected with a shoe raise. She could walk full weight bearing and independently with her day-to-day activities and function.</p><p><strong>Conclusion: </strong>MS can present with significant limb length discrepancy and angular deformities. This case aims to inform clinicians of the diagnosis and management of this rare condition and highlight the importance of regular follow-up after complex surgery, and the impact coronavirus disease-19 lockdowns had on the inability of patients to do so.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 2","pages":"55-59"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11823836/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433311","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":"Stealth Navigation with iFuse-TORQ Implant for Sacroiliac Joint Fusion Technique Guide.","authors":"Jia Bao Lin, Bryan L Demyan, Logan M Bushnell, Morgan T Turnow, Benjamin C Taylor","doi":"10.13107/jocr.2025.v15.i02.5276","DOIUrl":"10.13107/jocr.2025.v15.i02.5276","url":null,"abstract":"<p><strong>Introduction: </strong>Dysfunction of the sacroiliac (SI) joint exists in nearly one-third of patients with lower back pain. There are nuances in diagnosing SI joint dysfunction with a combination of physical exam maneuvers and intra-articular injections. The management of patients with SI joint pain can include posterior pelvic fixation, which traditionally has been described using fluoroscopy to obtain safe placement of implants.</p><p><strong>Case report: </strong>In this technique guide, we would like to introduce a novel technique of using Stealth navigation to facilitate SI fusion with the iFuse-TORQ implant.</p><p><strong>Conclusion: </strong>SI dysfunction is a common cause of low back pain that can be difficult to diagnose and treat. In this technique guide, we describe the successful treatment of SI pathology using the Stealth Navigation with the iFuse-TORQ implant.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 2","pages":"183-187"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11823858/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433431","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":"Computed Tomography Guided Biopsy and Gene X-pert MTB/Rif Ultra can be Deceptive in Spondylodiscitis - A Rare Case Report of Hodgkin's Lymphoma Mimicking Spondylodiscitis.","authors":"Vyankatesh Deshpande, Abhijit Pawar, Clevio Desouza, Hari Charan Adepu","doi":"10.13107/jocr.2025.v15.i02.5246","DOIUrl":"10.13107/jocr.2025.v15.i02.5246","url":null,"abstract":"<p><strong>Introduction: </strong>Tuberculosis (TB) is a leading cause of spinal infections, frequently presenting as spondylodiscitis. However, its clinical and radiological features can resemble those of Hodgkin's Lymphoma (HL). While Gene X-pert MTB/Rif Ultra and computed tomography (CT)-guided biopsies are common diagnostic tools for TB, they may sometimes be inconclusive. In such cases, HL should be considered as a differential diagnosis. Positron emission tomography-CT (PET-CT) scans are useful in assessing whether the disease is metabolically active. Accurate and timely diagnosis is essential for effective treatment, especially when initial tests suggest an infectious cause.</p><p><strong>Case report: </strong>A 16-year-old male presented with lower back pain radiating to the lower limbs and difficulty walking. Magnetic resonance imaging revealed vertebral body destruction suggestive of spondylodiscitis. Despite anti-tubercular therapy, his condition worsened. Gene X-pert MTB/Rif Ultra and multiple CT-guided biopsies initially suggested a granulomatous lesion but did not confirm TB. Subsequent imaging revealed systemic nodular lesions, raising the suspicion of malignancy. Immunohistochemical studies confirmed HL with positivity for CD15 and CD30. The patient responded positively to chemotherapy and has been in remission for 1 year.</p><p><strong>Conclusion: </strong>This case underscores the diagnostic challenges of distinguishing between spinal TB and HL. Initial tests such as Gene X-pert MTB/Rif Ultra and CT-guided biopsies can sometimes produce false negatives, leading to delays in accurate diagnosis and appropriate treatment. The use of PET-CT and detailed immune-histochemical analysis proved crucial in this case, emphasizing the importance of a comprehensive diagnostic approach when conventional treatments fail. This case contributes to the orthopedic literature by highlighting the need to consider HL in differential diagnoses and the role of advanced imaging and biopsies in ensuring timely and accurate diagnosis.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 2","pages":"106-110"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11823877/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433300","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 of Multiple Revised Hinge Total Knee Replacement -a Rare Case Report.","authors":"Muthusaravanakumar Meignanagure, Yogadeepan Dhakshinamurthi, Sathyamoorthy S Elangovan, Ganesh Ramesh Shetty","doi":"10.13107/jocr.2025.v15.i02.5282","DOIUrl":"10.13107/jocr.2025.v15.i02.5282","url":null,"abstract":"<p><strong>Introduction: </strong>Revision total knee replacements are very common now a days. Most common causes include early total knee replacement and increased life expectancy. Proper pre-operative planning and assessment are crucial for the appropriate management of revision cases.</p><p><strong>Case report: </strong>An 83-year-old gentleman came with a history of right knee pain and instability for past 1 year. He underwent bilateral TKR 20 years back, after which he underwent two revisions for his right knee 5 and 10 years following the first surgery. Intraoperatively, femoral and tibial components were found stable, and only poly wear was noted with hinge breakage and cement mantle interposition; hence, only hinge revision was done.</p><p><strong>Conclusion: </strong>Not all cases of revision need complete component replacement. Addressing intraoperative findings and appropriate management prevents complications.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 2","pages":"198-202"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11823838/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433390","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}