Journal of Orthopaedic Case Reports最新文献

{"title":"Long-term Patient-reported Functional Outcome after Pelvic Ring Injuries: Analysis using Two Different Types of Outcome Scores.","authors":"Sameer Aggarwal, Lav Mehta, Sandeep Patel, Vishal Kumar, Prasoon Kumar","doi":"10.13107/jocr.2025.v15.i06.5734","DOIUrl":"10.13107/jocr.2025.v15.i06.5734","url":null,"abstract":"<p><strong>Introduction: </strong>Pelvic ring injuries lead to significant patient morbidity and mortality. We evaluated long-term (>1 year) functional outcome of these patients using patient-reported outcome measures) using both generic health-specific and disease-specific outcome instruments.</p><p><strong>Materials and methods: </strong>Pelvic ring injury patients seen between 2015 and 2020 were called for a follow-up visit. Patient's demographic profile, mode and pattern of injury, associated injuries, management, and complications were recorded. Functional outcome assessment was made using two generic health-specific scores (SF-36 and short musculoskeletal functional assessment [SMFA]) and three disease-specific scores (Majeed pelvic score [MPS], Iowa pelvic score [IPS], and pelvic discomfort index [PDI]). Statistical analysis was performed to find the correlation between the two types of scoring systems. SF-36 scores of the study population were compared with normative data from the general population.</p><p><strong>Results: </strong>Of 56 patients (37 males, 19 females, mean age 32 years), there were 40 Tile B type and 16 Tile C type. 27 patients had other orthopaedic injuries, while 24 had nonorthopaedic injuries (14 - urological). 42 patients were operated and 14 were conservatively managed. The mean follow-up duration was 26.8 months. Mean (standard deviation [SD]) SF-36 physical component summary score was 64.01 (22.89) and mental component summary score was 63.79 (23.31). SMFA dysfunction index and SMFA bother index mean (SD) were 22.41 ± 11.75 and 25.97 ± 14.12, respectively. Mean (SD) MPS came as 85.93 (12.89) with 37 patients graded as \"excellent.\" The mean (SD) of IPS and PDI scores were 78.61 (9.40) and 21.70 (16.59), respectively. There was no statistical difference between the two types of scores when assessed using Spearman correlation tests. However, on comparison of study population mean SF-36 subset scores with general population norms, no domain of SF-36 could reach norm values. MPS cutoff of >85 (\"excellent\" outcome) could not include in itself a sufficient percentage of population with at-par SF-36 scores. Long-term sequelae of trauma were significantly associated with poor quality of life scores.</p><p><strong>Conclusion: </strong>Long-term physical functioning and quality of life in patients with pelvic ring injuries seem to be fair, although they are significantly lower than that of their peers in the general population.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 6","pages":"269-275"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12159635/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302339","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":"Medial Plantar Artery Dominance of the Plantar Arterial Arch: A Unique Anastomosis with Clinical Implications.","authors":"Jessica L Morehouse, Bryan G Beutel","doi":"10.13107/jocr.2025.v15.i06.5650","DOIUrl":"10.13107/jocr.2025.v15.i06.5650","url":null,"abstract":"<p><strong>Introduction: </strong>Forefoot structures are vascularized through the deep plantar arch, an anastomotic network classically described between the deep branch of the lateral plantar artery (dLPA) and the deep plantar artery (DPA). While it supplies the medial aspect of the plantar foot, the medial plantar artery (MPA) is not described as providing a vascular contribution to the deep plantar arterial arch.</p><p><strong>Case report: </strong>During routine cadaveric dissection of bilateral lower extremities in a 96-year-old Caucasian male, a unique anomaly was noted within the deep plantar arterial arch. The superficial branch of the medial plantar artery (sMPA) was found to course laterally at the level of the first metatarsophalangeal joint and anastomose with the DPA to form the deep plantar arch. No contribution was noted from the LPA. A total of 89 feet from 49 cadavers were subsequently examined, and no other donors exhibited this distinct morphology, resulting in an estimated prevalence of 2.3% of feet.</p><p><strong>Conclusion: </strong>This case study describes a novel bilateral plantar vascular anomaly and reviews the potential clinical significance of this variant, which should be considered during various reconstructive flap procedures of the foot.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 6","pages":"24-28"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12159659/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302342","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 Seven-Day Abbreviated Two-Stage Exchange Arthroplasty with Intra-Articular Antibiotic Irrigation for Chronic Periprosthetic Joint Infection of the Knee: A Case Report.","authors":"Nicolas S Piuzzi, Ignacio Pasqualini, Shujaa T Khan, Bryan D Springer, Brian C De Beaubien","doi":"10.13107/jocr.2025.v15.i06.5686","DOIUrl":"10.13107/jocr.2025.v15.i06.5686","url":null,"abstract":"<p><strong>Introduction: </strong>The current standard for treating chronic periprosthetic joint infection (PJI) in North America, a two-stage exchange arthroplasty, has success rates of 65-90% but involves prolonged interstage periods, increased morbidity, and a high 5-years mortality rate of up to 25%. These limitations have driven research into alternative approaches, such as intra-articular antibiotic (IAA) irrigation, which uses a specialized titanium spacer for localized antibiotic delivery over a 7-day period.</p><p><strong>Case report: </strong>A 53-year-old male with chronic PJI of the left knee underwent a novel rapid two-stage exchange arthroplasty using an IAA irrigation system. The first stage involved implant removal and placement of a specialized antibiotic delivery IAA device. During the 7-day interstage period, high-concentration local antibiotics (tobramycin and vancomycin) were administered. The second stage, performed 1 week later, included reimplantation with a total stabilized revision knee system. At 1-year post-surgery, the patient demonstrated excellent functional recovery, pain-free mobility, and no signs of recurrent infection.</p><p><strong>Conclusion: </strong>This case illustrates the potential of IAA in managing chronic PJI, offering rapid reimplantation and effective infection control. While promising, larger studies are needed to establish long-term efficacy and cost-effectiveness of this innovative approach.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 6","pages":"119-125"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12159660/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Rare Case of Lateral Femoral Condyle Osteonecrosis of Knee in a Young Patient Treated with Robotic Total Knee Replacement: A Case Report.","authors":"K T Rajashekhar, Kartik Mangsuli, Adarsh Krishna K Bhat","doi":"10.13107/jocr.2025.v15.i06.5704","DOIUrl":"10.13107/jocr.2025.v15.i06.5704","url":null,"abstract":"<p><strong>Introduction: </strong>Femoral condyle osteonecrosis of the knee leading to osteoarthritis is a rare entity, which is noticed more commonly in elderly women. Usually, the medial condyle is involved; lateral condyle involvement is extremely rare. Cases like these with occurrence in young individuals are even more rare and need thorough pre-operative evaluation, patient counseling, and intraoperative correlation for proper line of management. Based on the size and stage of the lesion, treatment options vary from medical management to biological therapies to arthroplasty in advanced cases.</p><p><strong>Case report: </strong>A 17-year-old male with a body mass index of 29.6 presented to our outpatient clinic with complaints of pain over the left knee, difficulty in walking, squatting, and sitting cross-legged. He was examined clinically, radiologically, and intraoperatively based on the findings and was diagnosed with osteonecrosis of the lateral femoral condyle femur extending into the trochlea with arthritic changes. After detailed discussion and counseling with the patient and relatives, keeping in mind the patient's demand and expectations, he underwent robotic-assisted total knee arthroplasty (TKA).</p><p><strong>Discussion: </strong>Knee osteonecrosis is a debilitating, progressive degenerative disease characterized by subchondral bone ischemia. It can lead to localized necrosis, tissue death, and progressive joint destruction. For this reason, it is essential to diagnose and treat this disease early to avoid subchondral collapse, chondral damage, and end-stage osteoarthritis, where the only management option is TKA.</p><p><strong>Conclusion: </strong>Osteonecrosis of the knee in young patients, particularly when there is extensive articular involvement and associated osteoarthritic changes, is quite challenging to treat. Although joint preservation is typically preferred in younger individuals, TKA may be the only viable option in advanced stages to restore function and quality of life. Robotic-assisted TKA allows for precise implant positioning and optimal alignment and thus enhances the functional outcome. Individualized treatment planning, thorough pre-operative evaluation, and comprehensive patient counseling are essential to achieving successful outcomes in such rare and complex cases.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 6","pages":"168-173"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12159651/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302285","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":"Successful Management of Atypical Bilateral Galeazzi Fractures with Unique Dorsal Displacement: A Case Report.","authors":"Warid Altaf, Amit Chaudhari, Parag Sancheti","doi":"10.13107/jocr.2025.v15.i06.5660","DOIUrl":"10.13107/jocr.2025.v15.i06.5660","url":null,"abstract":"<p><strong>Introduction: </strong>This case report presents an exceptionally rare occurrence of bilateral Galeazzi fractures with dorsal displacement of both distal radius fragments and the distal ulna in a 39-year-old male following a high-impact motorcycle accident. This specific injury configuration, which has not been categorized within the Walsh system, was effectively managed through open reduction and internal fixation utilizing limited contact dynamic compression plates.</p><p><strong>Case report: </strong>Fracture reduction was achieved using a bilateral Henry's approach, which resulted in spontaneous realignment of the distal radioulnar joints without requiring supplementary stabilization. Intraoperative stability was evaluated using the piano key test, and post-operative immobilization with above-elbow back slabs supported optimal recovery.</p><p><strong>Conclusion: </strong>At the 1-year follow-up, the patient demonstrated full functional recovery, including complete forearm range of motion and excellent grip strength. This case emphasizes the importance of prompt surgical management, precise anatomical realignment, and individualized intraoperative assessment in treating complex and rare bilateral forearm fractures. It also highlights the potential for excellent recovery outcomes with early and accurate intervention.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 6","pages":"48-51"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12159632/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302365","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 Devastating Chest Injury: A Case Report.","authors":"Bikram Keshari Kar, Sudarshan Behera, Nitin Kashyap, Rudra Narayan Dash, Rakesh Dhaka","doi":"10.13107/jocr.2025.v15.i06.5682","DOIUrl":"10.13107/jocr.2025.v15.i06.5682","url":null,"abstract":"<p><strong>Introduction: </strong>Sternal fractures, although uncommon, pose significant clinical challenges due to potential complicationssuch as respiratory compromise and chest wall instability. Prompt diagnosis and appropriate management are crucial to reduce morbidity.</p><p><strong>Case report: </strong>We report a case of a 43-year-old male who sustained displaced sternal and rib fractures following a road traffic accident. A midline incision allowed open reduction and internal fixation using a 3.5 mm locking reconstruction plate for the sternum and a 2 mm plate for the rib. Postoperative recovery was uneventful, with significant pain relief and improved respiratory function.</p><p><strong>Conclusion: </strong>This case reinforces the importance of early surgical intervention in unstable sternal fractures. Locking plate fixation offers superior biomechanical stability, faster healing, and fewer complications compared to conservative management or traditional wiring techniques.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 6","pages":"107-112"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12159656/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302281","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 Case Report on the Management of Peri-Prosthetic Fracture in a Post-TKA Patient with Rheumatoid Arthritis: Surgical Strategy and Treatment Outcome.","authors":"P M Mervin Rosario, Rathina Easwar V Ra","doi":"10.13107/jocr.2025.v15.i06.5708","DOIUrl":"10.13107/jocr.2025.v15.i06.5708","url":null,"abstract":"<p><strong>Introduction: </strong>Periprosthetic fractures (PPFs) around the knee following total knee arthroplasty (TKA) present a significant challenge in orthopedic management, particularly in patients with rheumatoid arthritis (RA). These fractures are influenced by factors such as bone stock quality, prosthetic status, polyethylene wear, and fracture reducibility. Proper classification and management strategies are essential to optimize outcomes and prevent complications.</p><p><strong>Case report: </strong>A 52-year-old female with RA sustained a right knee PPF following a trivial fall. Clinical and radiographic evaluation classified the fracture based on prosthetic stability and bone quality:• Type II fracture with a loose prosthesis requiring revision surgery.She underwent staged revision TKA including:1.Definitive surgery with revision TKA and bone grafting in figure.2.Postoperative rehabilitation to restore function figure.</p><p><strong>Conclusion: </strong>Management of PPFs in RA patients requires a comprehensive approach, including preoperative planning, prosthetic evaluation, osteoporosis management, and staged surgical intervention when necessary. This case highlights the importance of addressing osteoporosis alongside osteoarthritis in improving TKA outcomes. Further research is needed to refine treatment strategies for PPFs in RA patients.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 6","pages":"180-184"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12159657/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302280","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":"Popliteal Artery Injury Associated with Proximal Tibia Fracture: A Case Report.","authors":"Supratim Roy, Bhavesh Patidar, Yogesh Bhangale, C M Badole","doi":"10.13107/jocr.2025.v15.i06.5654","DOIUrl":"10.13107/jocr.2025.v15.i06.5654","url":null,"abstract":"<p><strong>Introduction: </strong>Acute popliteal artery thrombosis can occur as a result of direct trauma to the knee in cases of knee dislocations, distal femur fractures, and tibial plate fractures. Traction injury can induce indirect trauma, including popliteal artery laceration. Popliteal artery transection injury can have fatal effects for patients, since irreversible ischemia can occur in as little as 6-8 h.</p><p><strong>Case report: </strong>We report a rare case of 21-year-old male patient with closed displaced medial condyle fracture of tibia with popliteal artery thrombosis which was managed by intra-arterial thrombolysis.</p><p><strong>Conclusion: </strong>Popliteal artery thrombosis though a rare complication should be suspected and ruled out by imaging techniques in cases of blunt trauma to knee leading to tibial plateau fractures along with some neurological deficit and echymosis posterior to knee that suggests high intensity of trauma.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 6","pages":"34-38"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12159643/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302346","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":"Sculpting Solutions: 3D-Printed Models Transform Osteotomy Planning in Monteggia Fractures.","authors":"Y C Shravan, Suraj Prakash, M Mahesh, Praveen Salutagi","doi":"10.13107/jocr.2025.v15.i06.5702","DOIUrl":"10.13107/jocr.2025.v15.i06.5702","url":null,"abstract":"<p><strong>Introduction: </strong>A neglected Monteggia fracture refers to a proximal ulna fracture accompanied by a dislocated radial head that remains untreated for a duration exceeding 4 weeks following the initial injury. We present the case of a complex neglected Monteggia fracture and its unique pre-operative approach for radial head osteotomy using 3D-printed models.</p><p><strong>Case report: </strong>An 8-year-old girl presented with a delayed diagnosis of a Monteggia fracture, which had become increasingly complex due to late intervention and prior inadequate management. We discuss the clinical presentation, radiological features, differential diagnosis, treatment options, and long-term outcomes using a unique pre-operative approach.</p><p><strong>Conclusion: </strong>3D printing has been used around the world in orthopaedics for a myriad of fractures but we present the novel technique used in this case of a neglected Monteggia fracture which gave us access to tactile feedback of the radial head deformity with its relation to the ulnar and the capitellum which served as a blueprint in planning the osteotomy/reconstruction procedure thus improving our accuracy, efficiency intraoperatively and better overall patient outcome post-operatively.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 6","pages":"162-167"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12159626/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302363","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":"Arthroscopically Assisted Reduction and Internal Fixation for Tibial Plateau Fractures.","authors":"Mainak Roy, Madhan Jeyaraman, Naveen Jeyaraman, Ashok Shyam","doi":"10.13107/jocr.2025.v15.i06.5642","DOIUrl":"10.13107/jocr.2025.v15.i06.5642","url":null,"abstract":"<p><p>Tibial plateau fractures are complex intra-articular injuries resulting from high-energy trauma in young patients or low-energy mechanisms in osteoporotic individuals. Proper management is crucial to restore joint congruity, stability, and function, ultimately preventing long-term complications such as post-traumatic osteoarthritis. Open reduction and internal fixation have been the traditional approach but are associated with significant morbidity, including extensive soft-tissue damage and infection risk. Arthroscopically assisted reduction and internal fixation have emerged as a minimally invasive alternative that allows for precise fracture reduction, direct assessment of intra-articular soft-tissue injuries, and lower complication rates. This review discusses the indications, surgical technique, advantages, limitations, outcomes, and future perspectives of ARIF in the management of tibial plateau fractures.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 6","pages":"5-8"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12159616/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302303","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}