Journal of Orthopaedic Case Reports最新文献

{"title":"Functional Outcome of Distal Radius Fractures Managed by Minimally Invasive Plate Osteosynthesis: A Prospective Study of 20 Patients.","authors":"Ashwini Dondapati, Haemanath Pandian, Sheik Mohideen, E Pradeep, K V Arun Kumar, P Balamurugan","doi":"10.13107/jocr.2025.v15.i05.5630","DOIUrl":"https://doi.org/10.13107/jocr.2025.v15.i05.5630","url":null,"abstract":"<p><strong>Introduction: </strong>A distal radius fracture is a common injury that affects people of all ages. However, there are various therapy approaches that are controversial. Casting with or without closed reduction has long been considered a feasible option for treating distal radius fractures; alternative options include K-wire fixation and ligamentotax are with external fixation. However, with limited function and impairments, the results are frequently poor. \"Several studies have found that distal radius fractures treated with external fixation have good anatomical and functional outcomes, although there is a substantial risk of pin tract infection and nerve damage. Internal fixation and classic open reduction frequently result in severe soft tissue dissection and periosteal damage, which can cause infection, delayed union, and non-union. Fortunately, a new approach known as minimally invasive plate osteosynthesis (MIPO) has recently evolved, which can reduce soft tissue stripping and bone vascularity loss while improving fracture healing.</p><p><strong>Materials and methods: </strong>A prospective study of 20 patients with closed distal radius fractures was treated by the MIPO technique with a palmar locking plate between November 2022 and April 2023 and was followed up for 6 months.</p><p><strong>Results: </strong>There were 12 females and 8 males with an average age of 54.2 years. The average blood loss was around 52 ml approximately. 11 patients obtained excellent results, 7 cases had good results and 2 patients had moderate effects. The average disabilities of the arm, shoulder, and hand score after 6 months was about 10.2.</p><p><strong>Conclusion: </strong>In conclusion, two small incisions to implant a palmar locking plate by MIPO for distal radius fractures give good functional results as soft tissue handling is better compared to the conventional method of plating. But further research also should be carried out to explore more suitable treatment for specific individuals.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 5","pages":"269-273"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12064226/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143977113","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":"Aggressive Thoracic Spine Hemangioma in a 13-Year-Old Boy: A Case Report with Literature Review.","authors":"Gustavo de Almeida Nunes Gil, Daniela da Silveira Gravina, Guilherme Ranzi Cobalchini, Pedro Bertoldo Bossardi, Péricles Guazzelli Della Giustina","doi":"10.13107/jocr.2025.v15.i05.5588","DOIUrl":"https://doi.org/10.13107/jocr.2025.v15.i05.5588","url":null,"abstract":"<p><strong>Introduction: </strong>Most vertebral hemangiomas are latent and don't not require specific treatment; few cases present with symptoms, usually pain. Rarely, they manifest aggressively, causing neurological deficits from spinal cord compression.</p><p><strong>Case report: </strong>This case report describes a 13-year-old boy whose gait disturbance investigation revealed an aggressive T6 hemangioma.</p><p><strong>Conclusion: </strong>Diagnosis is typically determined by imaging changes. Surgical treatment is indicated for cases with neurological deficits. Emergency decompression with laminectomy is required for rapid, progressive deficits, with radiotherapy considered based on extraosseous involvement. Level of Evidence IV. Case report.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 5","pages":"141-145"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12064237/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144040887","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":"To Study the Functional Outcome of Vertebroplasty versus Conservative Management in Osteoporotic Fractures.","authors":"Arnav P Rathod, Yogesh B Rathod, Rajendra Baitule, Ganesh Pundkar, Hrishikesh S Saodekar, Arvind Suhagpure","doi":"10.13107/jocr.2025.v15.i05.5632","DOIUrl":"https://doi.org/10.13107/jocr.2025.v15.i05.5632","url":null,"abstract":"<p><strong>Introduction: </strong>Osteoporotic vertebral compression fractures (VCFs) significantly affect morbidity and quality of life. While conservative management (analgesics, bracing, and physiotherapy) is standard, vertebroplasty offers a minimally invasive alternative. This study compared the functional outcomes of vertebroplasty and conservative management in patients with osteoporotic fractures.</p><p><strong>Materials and methods: </strong>A prospective study of patients (≥60 years) with acute/subacute VCFs assessed pain (visual analog scale) and function (Oswestry disability index) at baseline, 3, 6, and 12 months. Patients underwent either vertebroplasty or conservative management. Statistical analysis included Chi-square and Mann-Whitney U-tests.</p><p><strong>Results: </strong>Among 162 patients (81 per group), vertebroplasty led to significantly greater pain relief and functional improvement at all follow-ups (P < 0.0001). However, new fractures were more frequent in the vertebroplasty group (9.68% vs. 3.23%).</p><p><strong>Conclusion: </strong>Vertebroplasty provides faster pain relief and better functional recovery but carries a higher risk of new fractures, requiring careful patient selection.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 5","pages":"274-278"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12064262/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143997592","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 Hydrodilation in Adhesive Capsulitis of Shoulder.","authors":"Sree Shangamithra, K V Arun Kumar, E Pradeep, Sheik Mohideen, V Y Ashwin, Esa Gokulakrishnan","doi":"10.13107/jocr.2025.v15.i05.5618","DOIUrl":"https://doi.org/10.13107/jocr.2025.v15.i05.5618","url":null,"abstract":"<p><strong>Introduction: </strong>Adhesive capsulitis, or frozen shoulder, is a painful and disabling condition characterized by progressive restriction of shoulder movement. Hydrodilatation, a minimally invasive procedure involving joint capsule distension, has been proposed as an effective treatment option. This study evaluates the functional outcomes of hydrodilatation in patients with adhesive capsulitis using the Constant-Murley score (CMS) and American Shoulder and Elbow Surgeons (ASES) score, along with pre- and post-procedure range of motion (ROM) assessments.</p><p><strong>Materials and methods: </strong>A prospective observational study was conducted on 30 patients diagnosed with adhesive capsulitis who underwent hydrodilatation. Functional and ROM improvements were assessed at baseline, post-procedure, 1 month, 3 months, 6 months, and 1 year. Data were analyzed using paired t-tests, and P < 0.05 was considered statistically significant.</p><p><strong>Results: </strong>The mean age of participants was 47.7 ± 9.8 years. The study population comprised 14 males (46.7%) and 16 females (53.3%), indicating a slightly higher prevalence among females. Significant improvements were observed in active and passive abduction, adduction, forward flexion, and external rotation (P < 0.001). Internal rotation restriction reduced from 59.1% to 40.9% (P < 0.001). Functional scores (ASES and CMS) showed progressive improvement, with ASES increasing from 41.1 ± 6.1 to 65.9 ± 8.4 and CMS from 44.4 ± 5.8 to 64.8 ± 9.1 at 1 year (P < 0.001).</p><p><strong>Conclusion: </strong>Hydrodilatation is an effective and well-tolerated intervention for improving shoulder function in adhesive capsulitis, with sustained benefits up to 1 year. Future studies should focus on standardizing treatment protocols and optimizing patient selection criteria.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 5","pages":"226-232"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12064221/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143987103","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":"Pathological Clavicle Fracture Secondary to Breast Carcinoma After a Minor Trauma and Fixed with Open Reduction and Internal Fixation: A Case Report.","authors":"Ben Murphy, Stephen Murphy, Andre McLeod, Padhraig O'Loughlin, David Morrissey","doi":"10.13107/jocr.2025.v15.i04.5480","DOIUrl":"https://doi.org/10.13107/jocr.2025.v15.i04.5480","url":null,"abstract":"<p><strong>Introduction: </strong>This is the first reported case of breast carcinoma metastasizing to the clavicle, causing a pathological fracture and subsequently being treated with open reduction and internal fixation (ORIF).</p><p><strong>Case report: </strong>A 60-year-old female presented with shoulder pain after a minor trauma while swimming. She had prodromal pain and a breast cancer history. The radiograph revealed a right clavicle fracture. She had ongoing pain and no union on radiographs, with concern for a pathological fracture. Bone biopsy was performed and consistent with metastatic breast carcinoma involving the clavicle. ORIF was performed for symptomatic control. A 14-month follow-up revealed a healed fracture and a full return to activity.</p><p><strong>Conclusion: </strong>A pathological clavicle fracture may be the presenting complaint of an unknown primary tumor or even signal recurrence of a previously treated malignancy. They can be challenging to diagnose and as such, we would urge surgeons to have a high index of suspicion in these cases. Excision of clavicular metastasis and partial or even full claviculectomy have been described in the literature. This is the first reported case of breast carcinoma metastasizing to the clavicle, causing a pathological fracture and subsequently being treated with ORIF. We would suggest that surgeons faced with this issue in the future consider it as a surgical option for pain relief and restoration of function in the otherwise fit and active patient.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 4","pages":"150-155"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11981497/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144012468","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":"Surgical Management of a Rare Complex Periprosthetic Fracture of Tibia in a Young Patient - Case Report and a Novel Technique.","authors":"Dilbans Singh Pandher, Nitish Khosla","doi":"10.13107/jocr.2025.v15.i04.5424","DOIUrl":"https://doi.org/10.13107/jocr.2025.v15.i04.5424","url":null,"abstract":"<p><strong>Introduction: </strong>Periprosthetic fractures of tibia are rarer form of injury after total knee arthroplasty. Most of these fractures occur in elderly patients with osteoporotic bones. Poor bone quality, age, and comorbidities restrict the management options for these fractures to constrained knee or megaprosthesis. However, in younger age group patients, considering the short survival of constrained or mega knee prosthesis in comparison to primary knee, every attempt should be made to restore the primary knee.</p><p><strong>Case report: </strong>We report the case of a rare combination type periprosthetic tibial fracture, that is, Felix Type 1B with Felix Type 4, in a 47-year-old female. Considering the young age of the patient and thus good bone quality, we planned for restoration of tibia with bone grafts while revising the tibial component with stemmed tibial base plate, and preserving the cruciate retaining femoral component. The avulsed tibial tuberosity was fixed with cerclage wire looped around the tibial stem. Patient was kept non-weight bearing for 4 weeks, followed by partial weight-bearing for next 6 weeks. Bone grafts were fully incorporated at the final follow-up. Patient had 0-110° range of motion with no limp or laxity in the operated limb.</p><p><strong>Conclusion: </strong>We conclude that in patients with good bone quality, even if a small part of the tibial plateau is preserved, stemmed tibia with reconstruction of the tibial plateau should be considered as an option to manage the Type 1B fractures, since these patients have high potential for osteointegration of the grafts and restoration of the primary knee will definitely have longer survival than constrained or mega knee prosthesis.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 4","pages":"6-10"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11981513/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144005604","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":"An Iliac Crest Avulsion with Meralgia Paresthetica in a Child: A Case Report.","authors":"Dylan Smith, Jake Peterson, Alejandro Marquez-Lara","doi":"10.13107/jocr.2025.v15.i04.5458","DOIUrl":"https://doi.org/10.13107/jocr.2025.v15.i04.5458","url":null,"abstract":"<p><strong>Introduction: </strong>This case report details an unusual presentation of an iliac crest (IC) avulsion fracture in a 15-year-old male, complicated by meralgia paresthetica (MP), despite no involvement of the anterior superior iliac spine (ASIS). IC avulsion fractures are rare, occurring in only 6.7% of pelvic avulsion fractures (PAF). They are rarely associated with MP, which typically correlates with ASIS injuries due to the proximity of the lateral femoral cutaneous nerve (LFCN).</p><p><strong>Case report: </strong>This case suggests a potential anatomical variation where the LFCN may traverse posteriorly to the IC, explaining the MP without ASIS involvement. The patient fully recovered with conservative treatment within 1 month, indicating that the MP symptoms likely resulted from localized inflammation rather than direct nerve injury.</p><p><strong>Conclusion: </strong>This case highlights the need for awareness of rare anatomical variations and their impact on clinical presentation, reinforcing the importance of a thorough physical examination. Prompt diagnosis is crucial, and while conservative management is effective for minimally displaced fractures, ongoing debates exist regarding surgical intervention criteria. Future research should focus on refining treatment guidelines for pediatric PAF and exploring anatomical variations to understand better and manage atypical symptoms.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 4","pages":"95-98"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11981516/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143997593","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 Outcomes of Retrograde Percutaneous Pinning for Shaft Fracture of Metacarpal Bone: A Case Series.","authors":"Takahiro Ushijima, Hikaru Ogawa, Tetsuo Kojima","doi":"10.13107/jocr.2025.v15.i04.5510","DOIUrl":"https://doi.org/10.13107/jocr.2025.v15.i04.5510","url":null,"abstract":"<p><strong>Introduction: </strong>Surgical treatment should be considered for metacarpal fractures that have severe angulation or shortening. Percutaneous pinning is a useful technique in that it is minimally invasive. Insertion of Kirschner wires using retrograde pinning is easier than that using antegrade or transverse pinning. On the other hand, anterograde pinning is also used for metacarpal shaft and neck fractures, but some complications such as perforation of the metacarpal head or laceration of the extensor tendons can occur. The purpose of this study is to evaluate the functional outcomes of simple retrograde pinning.</p><p><strong>Materials and methods: </strong>Thirteen patients (15 fingers) with simple metacarpal shaft fractures were enrolled in this prospective study. All patients were treated using percutaneous retrograde pinning following a brachial plexus block. Two intramedullary Kirschner wires were inserted from the metacarpal head to its base. Clinical outcomes included range of motion (ROM), post-operative complications, and evaluation using the Quick Disabilities of the Arm, Shoulder, and Hand score at final follow-up.</p><p><strong>Results: </strong>ROM in extension/flexion for each joint at the final follow-up was: Metacarpal phalangeal joint 3.1°/87.1°; proximal interphalangeal joint 2.0°/103.3°; and DIP joint 0°/74.1°. The percent total active ROM was 91.9% and the Quick-DASH score was 2.7 out of 100. Pin tract infections occurred in two fingers and were treated with oral antibiotics.</p><p><strong>Conclusions: </strong>In this study, retrograde Kirschner wire fixation was an acceptable technique for the treatment of displaced metacarpal fractures. This simple technique is suitable, especially for young patients in whom fractures are extraarticular and simple. It can correct deformity less invasively and provide good clinical outcomes.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 4","pages":"239-244"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11981494/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144026326","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":"Osteochondral Allograft Transplantation for a Large Focal Osteochondral Defect of the Lateral Femoral Condyle: Technical Note and Case Report.","authors":"Christos Koukos, Dimitrios Giotis, Michail Kotsapas, Stylianos Kapetanakis, Samundeeswari Saseendar, Theofylaktos Kyriakidis","doi":"10.13107/jocr.2025.v15.i04.5498","DOIUrl":"https://doi.org/10.13107/jocr.2025.v15.i04.5498","url":null,"abstract":"<p><strong>Introduction: </strong>Focal osteochondral defects in young individuals pose a significant challenge, often leading to chronic knee pain, functional limitations, and early onset of osteoarthritis if untreated. Osteochondral allograft (OCA) transplantation can offer a promising solution for large osteochondral defects. The aim of the study is to present a surgical approach for managing a large focal osteochondral defect in the lateral femoral condyle of a young, active patient through OCA transplantation.</p><p><strong>Case report: </strong>A 24-year-old male presented with atraumatic knee effusion, progressive pain, and impaired physical function. Imaging revealed a large osteochondral lesion in the lateral femoral condyle. After thorough pre-operative planning, including the creation of a 3D-printed model of the distal femur, the patient underwent lateral femoral condyle allograft transplantation. The procedure involved excision of the lesion, preparation of a size-matched OCA, and fixation with cannulated screws. Bone marrow aspirate concentrate was applied to enhance graft integration. Post-operative management included a progressive rehabilitation protocol with gradual knee flexion and weight-bearing. At 6 months postoperatively, the patient demonstrated significant clinical improvement with a Lysholm Knee Score of 89 and an International Knee Documentation Committee score of 87.4%. Follow-up imaging confirmed graft integrity and articular congruency.</p><p><strong>Conclusion: </strong>OCA transplantation is an effective surgical option for large osteochondral defects in the knee, providing satisfactory functional and clinical outcomes. This case highlights the importance of meticulous pre-operative planning, precise surgical technique, and structured post-operative rehabilitation in achieving successful results.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 4","pages":"199-204"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11981483/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144026605","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":"Soft Tissue Sarcoma Masquerading as Chronic Hematoma: A Case Report and Literature Review.","authors":"Amit Gupta, Aditya Menon, Manish Agarwal, Vikas M Agashe","doi":"10.13107/jocr.2025.v15.i04.5482","DOIUrl":"https://doi.org/10.13107/jocr.2025.v15.i04.5482","url":null,"abstract":"<p><strong>Introduction: </strong>Soft tissue sarcomas may resemble intramuscular hematomas in rare instances. We present a case of a patient diagnosed with pleomorphic spindle cell sarcoma that appeared similar to an intramuscular hematoma.</p><p><strong>Case report: </strong>A 45-year-old male presented with a painful, swollen, and pus-discharging area on his left thigh. Imaging revealed gas in the soft tissues, and the patient exhibited signs of severe illness, including abnormal blood work. Upon delving into his medical history, it was revealed that he had experienced a minor fall, after which his thigh gradually swelled over 6 months. Initially, an magnetic resonance imaging (MRI) diagnosed the condition as a hematoma. A surgeon performed an exploratory procedure and drainage without obtaining cultures or conducting a histopathological exam. Two weeks later, the site became infected, necessitating a second surgery based on radiological findings suggesting an infected hematoma. Deep tissue cultures grew Acinetobacter baumannii. Radiographs of the thigh showed air in soft tissues. The patient was referred to our institute suspecting gas gangrene. At the time of presentation, MRI showed a heterogeneous mass, leading to consultation with an orthopedic oncologist. Intraoperative frozen section analysis indicated a spindle cell neoplasm. The orthopedic oncosurgery team proceeded with en-masse excision, followed by additional debridement using vacuum-assisted closure. Enterobacter cloacae was isolated from deep tissue cultures, likely explaining the presence of gas pockets observed in soft tissues. Subsequently, a wide excision of the sarcoma was carried out, with skin grafting to cover the wound. Seven months later, the patient was undergoing chemotherapy for pulmonary metastases, with the surgical site showing no signs of infection. The patient succumbed to the disease 12 months after initial presentation at our institution, with metastasis being the cause of death.</p><p><strong>Conclusion: </strong>Healthcare professionals should exercise heightened caution when managing post-traumatic intramuscular hematomas. Although MRI results can aid in diagnosis, it is vital to consider them alongside clinical findings. To conclusively exclude the possibility of cancer, a biopsy followed by histopathological analysis is necessary.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 4","pages":"156-160"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11981520/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144031439","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}