Journal of Orthopaedic Case Reports最新文献

{"title":"Primary Total Hip Arthroplasty for a Displaced Femoral Neck Fracture in an Above-the-Knee Amputee: A Case Report.","authors":"Nathaniel J Starcher, Jignesh Patel, Andrew R Golden, Cameron A Kirk","doi":"10.13107/jocr.2026.v16.i10.8216","DOIUrl":"10.13107/jocr.2026.v16.i10.8216","url":null,"abstract":"<p><strong>Introduction: </strong>Femoral neck fractures in patients with ipsilateral above-knee amputations are uncommon and present unique diagnostic, biomechanical, and surgical challenges. The absence of a distal limb limits fracture reduction, intraoperative manipulation, and implant positioning, making standard treatment techniques difficult to perform. Although several fixation and arthroplasty strategies have been described for lower-extremity amputees, reports detailing primary total hip arthroplasty (THA) for displaced femoral neck fractures in young above-knee amputees remain scarce. This case highlights a practical surgical technique utilizing a temporary Steinmann pin as a lever arm to facilitate femoral control during arthroplasty and contributes to the limited orthopedic literature on management of these complex injuries.</p><p><strong>Case report: </strong>A 47-year-old Caucasian male with a history of traumatic left above-knee amputation sustained a displaced femoral neck fracture following a ground-level fall. Clinical evaluation and imaging demonstrated a displaced intracapsular femoral neck fracture with significant posterior tilt. Additional risk factors for fixation failure included tobacco use and poor bone quality. Given the patient's age, functional demands, and elevated risk of nonunion and osteonecrosis with internal fixation, primary THA was selected. During surgery, a fully threaded Steinmann pin was inserted into the residual femoral stump and used as a temporary lever arm to facilitate limb manipulation, femoral preparation, implant positioning, and stability assessment. The procedure was completed without complications, and the patient demonstrated satisfactory post-operative recovery with restoration of mobility and pain relief.</p><p><strong>Conclusion: </strong>This case demonstrates that primary THA may be a viable treatment option for select young above-knee amputees with displaced femoral neck fractures when multiple risk factors for fixation failure are present. The use of a temporary Steinmann pin provides a simple, reproducible, and minimally invasive method for intraoperative control of the residual limb. This technique may assist orthopedic surgeons managing complex hip fractures in amputee patients and expands the limited body of literature regarding arthroplasty strategies in this challenging population.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"16 10","pages":"142-146"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13646462/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149137219","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":"Chronic Neuropathy of the Lateral Antebrachial Cutaneous Nerve after Endoscopic Radial Artery Harvest: A Case Report.","authors":"Sean A Tzoucalis, Wesley D Troyer, Dennis J Warfield, Steven R Clendenen, Keith T Aziz","doi":"10.13107/jocr.2026.v16.i10.8174","DOIUrl":"10.13107/jocr.2026.v16.i10.8174","url":null,"abstract":"<p><strong>Introduction: </strong>Neurologic complications after radial artery harvest for coronary artery bypass grafting (CABG) remain incompletely characterized, particularly after endoscopic radial artery harvest (ERAH). As the radial artery has become the preferred second arterial conduit due to its superior long-term outcomes, ERAH has gained popularity as a minimally invasive alternative to open harvest with favorable cosmetic and wound outcomes. Although prior studies suggest neurologic symptoms are often transient, persistent sensory deficits may be underrecognized. The lateral antebrachial cutaneous nerve (LABC) is anatomically vulnerable during harvest, yet its injury has been reported mainly in open techniques. Because the sensory territories of the LABC and the superficial branch of the radial nerve overlap, LABC injury after ERAH may be overlooked. We present a detailed case of LABC injury following ERAH to further characterize this complication and inform pre-operative counseling.</p><p><strong>Case report: </strong>A 68-year-old female presented to our clinic with chronic left radial and dorsal forearm pain with onset a few days following a CABG. The pain radiates from the dorsal aspect of her thumb and index finger to just distal to her elbow on the lateral aspect of her forearm, and conservative management provided minimal relief. She had temporary symptom relief following hydrodissection and nerve block injection, noting recurrence shortly after the procedure. She was treated with surgical exploration, removal of foreign bodies, and nerve reconstruction with an allograft. Postoperatively, she experienced improvement in her pre- operative radiating forearm pain, but still had persistent numbness - which is expected in the early post-operative interval.</p><p><strong>Conclusion: </strong>We present a case of a 68-year-old patient who had LABC nerve injury after ERAH, demonstrating that clinically significant focal sensory neuropathy can occur despite the minimally invasive nature of this technique. This case highlights the anatomic vulnerability of the LABC within the harvest corridor and suggests that some post-operative radial-sided sensory symptoms may be underrecognized or misattributed due to overlapping cutaneous territories and limited nerve-specific assessment in prior studies.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"16 10","pages":"23-28"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13646560/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149137091","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":"Combined Cerclage and Figure-of-eight Tension-band Wiring without K-wire Versus K-wire Tension Band Wiring Fixation for Transverse Patellar Fractures: A Prospective Comparative Study.","authors":"Akshay V Pawar, Mohan M Desai, Kapil A Pawar","doi":"10.13107/jocr.2026.v16.i10.8292","DOIUrl":"10.13107/jocr.2026.v16.i10.8292","url":null,"abstract":"<p><strong>Introduction: </strong>Conventional modified tension-band wiring (TBW) using Kirschner wires (K-wires) is widely used for displaced transverse patellar fractures but is associated with implant prominence, irritation, migration, and breakage. K-wire-free fixation using combined cerclage and TBW may provide stable fixation while reducing hardware-related complications.</p><p><strong>Materials and methods: </strong>Prospective comparative study of 156 patients with transverse patella fracture with follow-up of at least 18 months. Group A consisted of 82 patients treated with K-wire TBW and Group B consisted of 74 patients treated with combined cerclage TBW without K-wires. Clinical assessment was done by knee range of motion, extension lag, and presence of local tenderness. Pain assessment was done using the Visual Analog Scale. Functional assessment was performed using the Bostman knee score. Radiological assessment was done using standard radiographs of the knee. Complications and implant removal were also assessed. The Chi-square test, Fisher's exact test, and independent-samples t-test were used to assess association. P < 0.05 was considered satistically significant.</p><p><strong>Results: </strong>Both groups were comparable in demographics such as age, gender, body mass index, and follow-up period. The combined cerclage TBW without K-wires group demonstrated significantly lower pain scores at 6 weeks, 3 months, and 6 months and less knee tenderness at 6 weeks and 3 months. Bostman scores were significantly higher at 6 months and 1 year. The pain and stair-climbing components of the Bostman score were significantly better in the combined cerclage group at 6 months and 1 year. Implant migration/breakage (2% vs. 17%) and hardware irritation (10% vs. 17%) were significantly reduced with combined cerclage TBW. Implant removal preference (16% vs. 43%) and actual removal surgery (13% vs. 31%) were also significantly lower.</p><p><strong>Conclusion: </strong>The study demonstrates that combined cerclage TBW without K-wires provides functional outcomes comparable to those of conventional modified TBW with K-wires at 1 year, while potentially reducing K-wire-related complications such as implant migration, prominence, irritation, and subsequent implant removal surgery.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"16 10","pages":"368-375"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13646540/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149137145","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":"Degloving in Disguise: Managing a Delayed Spinal Morel-Lavallée Lesion after Thoracic Fracture-Dislocation.","authors":"Henry Morar, Funiba Ngwa, Dhara Patel, Theresa Pazionis","doi":"10.13107/jocr.2026.v16.i10.8198","DOIUrl":"10.13107/jocr.2026.v16.i10.8198","url":null,"abstract":"<p><strong>Introduction: </strong>Back-degloving injuries are rare but severe consequences of high-energy blunt trauma. These injuries involve the separation of skin and subcutaneous tissue from the underlying fascia, muscle, or bone, and may present as open or closed lesions. Closed injuries, or Morel-Lavallée lesions, can be particularly insidious due to intact dermis concealing deep fluid accumulation, necrosis, and infection.</p><p><strong>Case report: </strong>We present the case of a 61-year-old male who sustained extensive polytrauma following a motorcycle-versus-car collision, with emphasis on his spinal injuries and delayed-onset closed thoracolumbar degloving lesion. Spinal injuries consisted of a T11-T12 fracture-dislocation. Initial management of the spinal lesion included debridement of the wound and posterior spinal fusion. In the post-operative period, he developed increasing dorsal soft-tissue swelling, wound dehiscence, and purulent discharge. The lesion was managed with serial incision and drainage procedures, negative pressure wound therapy, and broad-spectrum intravenous antibiotics. He was later discharged with negative wound and blood cultures and a closed wound, though he was later readmitted.</p><p><strong>Conclusion: </strong>This case underscores the complexity of managing spinal trauma complicated by closed degloving injuries and highlights the critical need for early recognition, advanced imaging, and a multidisciplinary approach to optimize outcomes in polytrauma patients. Clinicians should maintain a high index of suspicion for closed infections or degloving injuries in patients with persistent or evolving tissue swelling overlying spinal instrumentation. A delayed diagnosis may precipitate wound breakdown, hardware compromise, and chronic infection. Prompt imaging and more frequent physical examinations, as well as coordinated management by different surgical teams, are essential to mitigate the morbidity from these injuries.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"16 10","pages":"90-96"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13646830/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149137099","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 Hip Arthroplasty in the Adolescent Population: A Case Series.","authors":"Jennafir C Ernst, Caitlyn N Patton, Benjamin M Frye","doi":"10.13107/jocr.2026.v16.i10.8324","DOIUrl":"10.13107/jocr.2026.v16.i10.8324","url":null,"abstract":"<p><strong>Introduction: </strong>Total hip arthroplasty (THA) is well-studied in adults but is not in younger populations.</p><p><strong>Case series: </strong>Five adolescent THA patients from one institution were identified. Surgical indications included trauma, avascular necrosis, developmental hip dysplasia, and Perthes disease. Patients experienced hip pain impacting activities of daily living. At the most recent follow-up, patients were pain-free, ambulated without an aid or limp, and had returned to desired activities. Constructs were cementless; bearing surfaces included ceramic-on-ceramic and ceramic-on-polyethylene. Approaches included direct anterior and posterior. Radiographs demonstrated osseointegration of all components at the most recent follow-up. There were no major complications (dislocation, component loosening requiring revision, or infection).</p><p><strong>Conclusion: </strong>THA in adolescent patients demonstrated significant clinical improvement in pain, low complication rates, and good implant survivorship, with patients able to return to desired activities.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"16 10","pages":"493-499"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13646797/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149137236","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":"Clinical and Functional Outcomes of Closed Intramedullary Interlocking Nailing in Extra-articular Distal Tibial Fractures: A Prospective Observational Study.","authors":"Mohit Dashore, Mrudul Shah, Ankit Jain, Parv Bhargava, Prateek Sahu, Abhishek Chouhan","doi":"10.13107/jocr.2026.v16.i10.8294","DOIUrl":"10.13107/jocr.2026.v16.i10.8294","url":null,"abstract":"<p><strong>Introduction: </strong>Extra-articular distal tibial fractures are difficult to manage because of poor soft-tissue coverage, limited vascularity, and the tendency for malalignment and delayed union. Closed intramedullary interlocking nailing has become an increasingly preferred treatment option because it preserves fracture hematoma and periosteal blood supply.</p><p><strong>Aims: </strong>The aim of the study was to evaluate the clinical and functional outcomes of closed intramedullary interlocking nailing in extra-articular distal tibial fractures.</p><p><strong>Materials and methods: </strong>This prospective observational, single-center study was conducted in the Department of Orthopaedics, People's College of Medical Sciences and Research Centre, Bhopal, between March 2024 and December 2025. Fifty consecutive patients aged 18-60 years with extra-articular distal one-third tibial fractures (closed or Gustilo-Anderson type I open fractures) were treated with closed intramedullary interlocking nailing. Functional assessment using the modified American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Score was performed preoperatively and at 2, 6, 9, and 12 weeks and 6 months. Radiographic union, alignment, progression of weight-bearing, and post-operative complications were assessed. Repeated AOFAS measurements were analyzed using the Friedman test.</p><p><strong>Results: </strong>The mean age was 37.74 ± 12.26 years, and 80% of patients were male. Road traffic accidents accounted for 90% of injuries. AOFAS scores increased from 50.30 ± 1.99 preoperatively to 87.74 ± 7.85 at 6 months. Longitudinal analysis demonstrated a significant change in AOFAS scores across the six assessment points (Friedman χ2 = 239.80, df = 5, P < 0.001; Kendall's W = 0.959). At 6 months, 60% had excellent and 32% good AOFAS categories. Superficial infection occurred in 8%, delayed union in 4%, non-union in 4%, and malunion in 2%.</p><p><strong>Conclusion: </strong>In this selected cohort of adults with extra-articular distal one-third tibial fractures, closed intramedullary interlocking nailing was associated with progressive short-term functional improvement and generally satisfactory fracture healing. Because the study was small, single-center, non-comparative, and limited to 6 months of follow-up, it does not establish superiority over plating, external fixation, or other treatment strategies, and longer comparative studies are required.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"16 10","pages":"376-383"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13646574/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149137150","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":"Recurrent Ventral Scapular Osteochondroma Presenting with Pseudo-winging in an Adolescent: A Case Report and Follow-up of a Previously Published Case.","authors":"Rui Nobre Chaves, António Lemos Lopes, Sara Machado Neves, Afonso Teles, Henrique Lascasas Pinto, Rita Macedo Sousa","doi":"10.13107/jocr.2026.v16.i10.8236","DOIUrl":"10.13107/jocr.2026.v16.i10.8236","url":null,"abstract":"<p><strong>Introduction: </strong>Osteochondroma is the most common benign bone tumor, but involvement of the scapula is uncommon. Lesions arising from the ventral surface of the scapula may remain clinically occult until they produce pain, crepitus, snapping, or static scapular pseudo-winging. Recurrence after surgical excision is rare and is generally related to residual cartilage cap or incomplete resection, particularly in skeletally immature patients. We report a recurrent ventral scapular osteochondroma in an adolescent previously treated for pseudo-winging, emphasizing diagnostic vigilance and complete excision.</p><p><strong>Case report: </strong>A male adolescent previously underwent excision of a symptomatic ventral osteochondroma of the left scapula at 11 years of age. The index episode had presented as painful static scapular pseudo-winging with normal neurovascular examination and imaging demonstrating an osteochondroma arising from the ventral inferior scapular region. After an initially favorable outcome, he re-presented at 14 years of age with recurrent pain and deformity of the scapular region. Clinical examination again demonstrated static pseudo-winging rather than dynamic neuromuscular winging. Imaging confirmed recurrence of a ventral scapular osteochondroma. Complete surgical excision was performed through a posterior parascapular approach. The post-operative course was uneventful, with resolution of pain and restoration of normal scapular contour and scapulothoracic motion.</p><p><strong>Conclusion: </strong>Recurrent ventral scapular osteochondroma is rare but should be considered when pseudo-winging reappears after previous excision. This case underlines the importance of distinguishing static pseudo-winging from true dynamic scapular winging, obtaining appropriate cross-sectional imaging, and achieving complete resection at the base of the lesion to minimize recurrence risk.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"16 10","pages":"203-207"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13646575/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149137249","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":"Angiomatoid Fibrous Histiocytoma in a Child with Hereditary Spherocytosis: A Rare Co-occurrence.","authors":"Sandeep Sehrawat, Venkatesan Sampath Kumar, Love Kapoor, Asit Ranjan Mridha, Dheeraj Yadav, Shah Alam Khan","doi":"10.13107/jocr.2026.v16.i10.8188","DOIUrl":"10.13107/jocr.2026.v16.i10.8188","url":null,"abstract":"<p><strong>Introduction: </strong>Angiomatoid fibrous histiocytoma (AFH) is a rare soft-tissue tumor of low malignant potential, and its radiological appearance is often non-specific, mimicking benign cysts, hematomas, or infections, necessitating histopathological and immunohistochemical confirmation. While hematological malignancies have been reported in Hereditary Spherocytosis (HS), no association with AFH has been documented. We present the first case of AFH involving the shoulder soft tissue in a post-splenectomy adolescent with HS, highlighting diagnostic challenges and a possible link between chronic hematologic stress and mesenchymal tumor development.</p><p><strong>Case report: </strong>A child in his early adolescence presented with a 2-month history of right shoulder pain and swelling, which was progressively increasing in size, firm, painful, and associated with fever. His total leukocyte count was 15,500/mm3, and C-reactive protein was 152 mg/L. He had a history of multiple blood transfusions since the age of four. Eight months prior, he was diagnosed with HS and underwent total splenectomy for massive splenomegaly. Magnetic resonance imaging revealed a soft-tissue lesion posterior to the glenoid, abutting the spine of the scapula. A bone scan ruled out an infectious etiology. Ultrasound-guided fine needle aspiration cytology showed no organisms and was negative for malignant cells. Surgical excision of the mass was performed, and histopathology confirmed the diagnosis of AFH.</p><p><strong>Conclusion: </strong>This case highlights the importance of considering AFH in the differential diagnosis of soft-tissue tumors in children with hematologic disorders.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"16 10","pages":"63-68"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13646817/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149136904","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":"Bilateral Global Pincer-Type Femoroacetabular Impingement with CAM Lesions: Arthroscopic Management Using a Peripheral First Approach.","authors":"Sujit Jos, Shobit Joseph Kunnamkottu, Prannoy Paul, Rakshit Jayaram, Mohammed Jishar Nambiyath","doi":"10.13107/jocr.2026.v16.i10.8190","DOIUrl":"10.13107/jocr.2026.v16.i10.8190","url":null,"abstract":"<p><strong>Introduction: </strong>Pincer type of femoroacetabular impingement might have a focal or global presentation. The global form has extreme acetabular coverage and the clinical condition of the patient is affected by the presence of an associated CAM lesion as it severely reduces the range of movements at the hip joint.</p><p><strong>Case report: </strong>A male patient of age 54 years presented to the orthopedics outpatient department with complaints of severe restriction of movements of both hip joints, which had evolved over a few years. Examination showed severe restriction of rotation and extension of hip joint with stiffness of spine. Magnetic resonance imaging of both hip joints showed bilateral large pincer lesions and calcification of capsule of hip joint with a non-visualized anterosuperior labrum and thinning of the articular cartilage. He underwent arthroscopic rim trimming of the pincer lesions and osteoplasty of the CAM lesions by the peripheral compartment first approach.</p><p><strong>Conclusion: </strong>Although pincer and CAM lesions in the hip are relatively common, severe cases in the global form are rare and difficult to manage surgically. The arthroscopic technique with the peripheral compartment first technique is an effective solution in trimming the pincer and CAM lesions effectively and thus improving the patient's clinical condition.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"16 10","pages":"69-72"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13646821/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149137084","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":"Lipofibromatous Hamartoma of the Median and Ulnar Nerves: A Case Report.","authors":"Patricio A Alfaro, Lucas G Silva, Marion E Hohf","doi":"10.13107/jocr.2026.v16.i10.8202","DOIUrl":"10.13107/jocr.2026.v16.i10.8202","url":null,"abstract":"<p><strong>Introduction: </strong>Lipofibromatous hamartoma (LFH) is a rare, benign tumor of peripheral nerves characterized by fibroadipose infiltration of the epineurium and perineurium. It most frequently involves the median nerve and is rarely seen with concomitant ulnar nerve involvement.</p><p><strong>Case report: </strong>We report a 28-year-old male with a 13-year history of a slowly progressive mass over the volar aspect of the left hand and wrist, associated with persistent hypoesthesia in the thumb and intermittent paresthesia in the ring and little fingers. Magnetic resonance imaging (MRI) revealed the pathognomonic \"coaxial cable\" and \"spaghetti\" signs involving both the median and ulnar nerves. The patient underwent extended neurolysis of both nerves with carpal tunnel and Guyon's canal release. Histopathology confirmed LFH without atypia. At 12-month follow-up, he showed sustained improvement in pain and sensory symptoms, with complete return to work.</p><p><strong>Conclusion: </strong>Concomitant LFH of the median and ulnar nerves is extremely rare. MRI provides pathognomonic diagnosis, and extended neurolysis without tumor resection can achieve favorable functional outcomes.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"16 10","pages":"103-105"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13646467/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149137104","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}