Journal of Orthopaedic Case Reports最新文献

{"title":"Limitations of Focused Assessment with Sonography for Trauma in Pelvic Trauma: A Retrospective Review of False-Positive Results and Non-Therapeutic Laparotomies.","authors":"Pankaj Kumar, Swastik Sourav Mishra, Mantu Jain, Sujit Tripathy, Kasthala Sanjay Raj, Siddharth Satyakam Pradhan","doi":"10.13107/jocr.2025.v15.i04.5512","DOIUrl":"https://doi.org/10.13107/jocr.2025.v15.i04.5512","url":null,"abstract":"<p><strong>Introduction: </strong>Focused assessment with sonography for trauma (FAST) is an important adjunct for quickly detecting intra-abdominal hemorrhage. The study was aimed to identify the incidence of non-therapeutic laparotomies with positive FAST result and pelvic fracture.</p><p><strong>Materials and methods: </strong>A retrospective review of prospectively maintained data was conducted to identify cases of pelvic fracture with positive FAST results. Cases with non-therapeutic laparotomies were analyzed for the cause of false FAST positive result. The data were collected and analyzed for the mechanism of injury, associated injuries and injury severity.</p><p><strong>Results: </strong>Out of 195 cases of pelvic fracture with positive FAST result, only 5 cases (2.5%) had non-therapeutic laparotomies. Most were operated without a computed tomography scan due to hemodynamic instability. One patient was operated in view of peritonitis. Most common type of the injury requiring operative intervention was a vertical shear fracture. One patient was managed with an immediate external fixator, while three underwent a definitive pelvis fixation at a later date. One patient was managed conservatively.</p><p><strong>Conclusion: </strong>FAST has a high sensitivity for intra-abdominal bleeding. However, retroperitoneal hematoma in pelvic fractures can lead to false-positive FAST results. Therefore, we advocate for a comprehensive approach encompassing clinical judgment, additional imaging for stable patients, the engagement of a multidisciplinary team, and surgical expertise to ensure optimal patient care and outcomes.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 4","pages":"245-251"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11981531/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144026249","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":"From Trivial Trauma to Major Surgery: Navigating Skeletal Metastases with Sequential Hip Arthroplasty for Pathological Femoral Neck Fractures in Triple-Negative Breast Cancer.","authors":"Krishnan Nallayarasu, B Mohan Choudhary, Kevin Lourdes, Arjun Ganesh, P Velmurugan","doi":"10.13107/jocr.2025.v15.i04.5468","DOIUrl":"https://doi.org/10.13107/jocr.2025.v15.i04.5468","url":null,"abstract":"<p><strong>Introduction: </strong>Pathological fractures are becoming a very common entity in routine clinical practice due to the widespread prevalence of a wide variety of primary tumors in metropolitan and rural areas. Pathological fractures are often underdiagnosed by surgeons in day-to-day practice. Managing such missed fractures in patients is a nuisance. In this case report, we look into one such patient who came to us with successive serial fractures of multiple long bones.</p><p><strong>Case report: </strong>A 49-year-old lady presented to us with complaints of right hip with no history of trauma. Plain radiographs were done which revealed a right neck of femur fracture. She underwent right hip bipolar hemiarthroplasty. Forty-five days later she had another trivial injury to her left hip and was diagnosed through radiographs as left neck of femur fracture, for which she underwent left hip bipolar hemiarthroplasty.</p><p><strong>Conclusion: </strong>A thorough evaluation of bony metastasis is required in the management of pathological fractures or impending fracturesto prevent missing such fractures and early surgical intervention provides good outcome in most cases.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 4","pages":"121-125"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11981478/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144023567","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 Xanthogranulomatous Osteomyelitis of Radius Presenting as Pathological Fracture - A Case Report.","authors":"Syam Gangadharan Nair, Jittu Alex, Riyas Nazar, John Thayyil John","doi":"10.13107/jocr.2025.v15.i04.5462","DOIUrl":"https://doi.org/10.13107/jocr.2025.v15.i04.5462","url":null,"abstract":"<p><strong>Introduction: </strong>Xanthogranulomatous inflammation is a specific form of chronic inflammatory disease histologically characterized by collection of foamy macrophages along with polymorphonuclear leukocytes, activated plasma cells, and lymphocytes of polyclonal origin, in a mosaic-like pattern. The involvement of xanthogranulomatous inflammation of the bone is termed as xanthogranulomatous osteomyelitis (XO). It often presents as a mass-like lesion extending into adjacent structures and so radiological features have little role in pointing to a diagnosis. Definitive diagnosis can only be made by histopathological examination.</p><p><strong>Case report: </strong>This report describes a case of 62-year-old male patient who sustained a pathological fracture of shaft of radius which on evaluation, was diagnosed as XO, its management and 2- year follow-up results. This case report highlights a rare cause of pathological fracture, that is, XO.</p><p><strong>Conclusion: </strong>Clinical examination and radiology have little role in the diagnosis of the condition. Definitive diagnosis is achieved by histopathological examination and the disease has a good prognosis.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 4","pages":"104-107"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11981496/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144030841","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":"Tripartite Patella: A Rare Case Report.","authors":"V Ravi Kiran, Udit K Jayant, M L V Sai Krishna, Sanjay Singh Rawat","doi":"10.13107/jocr.2025.v15.i04.5452","DOIUrl":"https://doi.org/10.13107/jocr.2025.v15.i04.5452","url":null,"abstract":"<p><strong>Introduction: </strong>Multipartite patella is an incidental diagnosis, rarely symptomatic, and described scantily in the literature. Symptoms are secondary to direct injury or repetitive micro-trauma, resulting in the separation of fibro-cartilaginous joints across the multiple patellar components. Treatment is usually conservative, and occasionally, in resistant cases, surgery is advised.</p><p><strong>Case report: </strong>We present a 50-year-old with a tripartite patella who presented after a history of falls and incidentally discovered a bipartite patella of the other knee. The symptoms of the tripartite patella were managed conservatively.</p><p><strong>Conclusion: </strong>Symptomatic multipartite patella should be distinguished from traumatic patella fracture. In old patients, a high index of suspicion is required to differentiate between a traumatic disruption of the multipartite patella with quadriceps avulsion and an avulsion fracture of the patella. Suppose there is a high index of suspicion. In that case, magnetic resonance imaging should be preferred to explain the signs and symptoms by noting bone marrow edema, partial or complete rupture of quadriceps, and quadriceps fat pad edema. We suggest that surgical decisions to either fix the fragment or excise be taken intraoperatively based on size, site, amount of articular surface, and associated tendon avulsion.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 4","pages":"80-83"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11981522/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144000721","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":"Chondroblastoma of the Proximal Humerus in a 12-years-old Female: A Case Report and a Review of the Literature.","authors":"Emilio Valdes-Davila, Omar Fernando Rodríguez-Rodríguez, David Muñoz-Leija","doi":"10.13107/jocr.2025.v15.i04.5446","DOIUrl":"https://doi.org/10.13107/jocr.2025.v15.i04.5446","url":null,"abstract":"<p><strong>Introduction: </strong>This case is important because it highlights a rare presentation of chondroblastoma, given the tumor's male predominance and its uncommon occurrence in females. The proximal humerus is one of the less frequently reported sites for chondroblastoma, additionally, the tumor exhibited aneurysmal changes, a known risk factor for recurrence. This case contributes to the orthopedic literature by providing insight into the clinical and imaging features, challenges in diagnosis, and management strategies for this rare tumor.</p><p><strong>Case report: </strong>A 12-years-old girl from México, presented with progressive right shoulder pain after a traction injury, clinical examination showed limited abduction and a palpable mass, imaging and pathology tests revealed a lesion in the proximal humerus. Due to the tumor's extent, en bloc resection with an allograft and fixation was performed, a procedure not commonly used in these patients, to restore morphology and function.</p><p><strong>Conclusion: </strong>This case underscores the importance of early recognition and a multidisciplinary approach to managing chondroblastoma, especially in atypical presentations, such as in young females. En bloc resection combined with allograft reconstruction provided a favorable clinical outcome, minimizing recurrence risk and preserving joint function. This report contributes to the orthopedic literature by documenting a rare presentation and emphasizing the critical role of individualized surgical strategies and post-operative rehabilitation in achieving optimal outcomes.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 4","pages":"63-68"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11981486/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143998058","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":"Osteomyelitis of the Odontoid Process: A Literature Review and Recommendations.","authors":"Justin Choi, Krishnamurthi Sundaram","doi":"10.13107/jocr.2025.v15.i04.5516","DOIUrl":"https://doi.org/10.13107/jocr.2025.v15.i04.5516","url":null,"abstract":"<p><strong>Introduction: </strong>Odontoid osteomyelitis (OOM) is a rare clinical entity that requires a high degree of suspicion for diagnosis. A literature review was conducted to make recommendations for early diagnosis and best practices in the management of OOM.</p><p><strong>Materials and methods: </strong>Literature review of all available articles, all of which were case studies or case series, published in PubMed and Google Scholar.</p><p><strong>Results: </strong>There were 47 articles published from 1944 to 2024 with n = 54 with confirmed diagnosis of OOM. The median age was 52 years and 64% were male. Likely precipitating factors were identified in 29 patients (54%). Neck pain was the most common presentation (87%), followed by fever (57%) and neck stiffness (44%). Neurological symptoms developed in 50% of patients. Magnetic resonance imaging (MRI) was frequently used (85%) with 72% of these indicating OOM. Staphylococcus aureus was the most common pathogen (82%). Surgery was performed in 59% of patients.</p><p><strong>Conclusion: </strong>To avoid delayed or misdiagnosis of this rare entity, a thorough history and physical should be performed to identify patient risk factors, salient complaints, and potential nidi of infection. MRI remains the gold standard in diagnosis. Early pathogen identification with appropriate antibiotics, and incision and drainage when possible, can treat OOM while avoiding surgery. However, surgery is indicated in cord compression secondary to atlantoaxial subluxation, a common and feared complication of OOM.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 4","pages":"262-269"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11981528/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143998059","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":"Failed Loop Endobutton Acromioclavicular Joint Reconstruction Treated with Duo Figure of 8 FiberTape Augmented Autogenic Graft Wrapping Technique: A Case Report.","authors":"Saurabh Singh, Sushit Kumar Sonu, Rahul Patel, Kumar Prashant, Himanshu Nagar","doi":"10.13107/jocr.2025.v15.i04.5494","DOIUrl":"https://doi.org/10.13107/jocr.2025.v15.i04.5494","url":null,"abstract":"<p><strong>Introduction: </strong>Acromioclavicular joint (ACJ) injuries are prevalent among young, active individuals and account for a significant proportion of shoulder girdle and collision sports injuries. The Rockwood classification system categorizes these injuries from Type I to VI, guiding treatment from conservative management to surgical intervention. Despite various surgical techniques, including the Fiber-loop Endobutton method, failure rates, and complications remain a concern, particularly in cases of post-operative instability.</p><p><strong>Case report: </strong>A 50-year-old male presented with persistent right shoulder pain and deformity following an initial Type-V ACJ injury from a road traffic accident. The patient had undergone surgical stabilization with a Fiber-loop Endobutton construct. However, 17th days post-surgery, he experienced a recurrence of pain and deformity, with radiographs revealing the failure of the initial repair. Subsequent imaging indicated a mal-positioned Endobutton and potential coracoid blowout, likely due to inadequate drill hole placement. Three weeks later, the patient underwent revision surgery using a double figure-of-8 autogenic loop reconstruction with FiberTape and hamstring tendon graft. The procedure involved removing the failed hardware, drilling new holes in the clavicle, and securing the ACJ with FiberTape and a hamstring graft. The graft was looped around the coracoid and clavicle in a figure-of-8 manner to replicate acromioclavicular ligament anatomy and ensure both horizontal and vertical stability. At 6 weeks, follow-up radiographs demonstrated near-anatomic alignment of the ACJ and coracoclavicular. The patient reported minimal pain and regained a near-full range of motion. By 6 months, while slight radiographic changes were noted, the patient remained asymptomatic with excellent functional outcomes and minimal limitations.</p><p><strong>Conclusion: </strong>This case highlights the challenges of managing post-operative instability in ACJ injuries. The successful use of a dual figure-of-8 graft technique provides a viable solution for revision surgery, offering satisfactory stability and functional recovery. Further research is needed to optimize salvage techniques for complex cases.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 4","pages":"186-191"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11981503/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143970603","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":"Gouty Arthritis with Massive Tophaceous Deposits Involving Bilateral Metatarsophalangeal Joints, Surgical Treatment with Excision and Reconstruction - A Case Report.","authors":"Janardhana Aithala P, Dinesh Kumar Shetty","doi":"10.13107/jocr.2025.v15.i04.5448","DOIUrl":"https://doi.org/10.13107/jocr.2025.v15.i04.5448","url":null,"abstract":"<p><strong>Introduction: </strong>Gout is characterized by the deposition of monosodium urate crystals and the formation of tophaceous deposits, which can lead to arthritis and bony erosions. While bony erosions in gouty arthritis are common, massive erosions of bone with the destruction of complete bone are rarely described.</p><p><strong>Case report: </strong>We report a case of gouty arthritis with bilateral first metatarsophalangeal (MTP) joint involvement with bone erosion involving adjacent bones. Both sides were treated by surgical treatment with the excision of entire tophaceous deposits, the first MTP joint and the adjacent involved bones followed by reconstruction using interposition grafts. The patient was able to walk comfortably at the end of 6 months, with good cosmetic correction and healing of the wound.</p><p><strong>Conclusion: </strong>Surgical excision and reconstruction with intercalary graft for a massive tophaceous deposit around the first MTP joint can give satisfactory results.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 4","pages":"69-73"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11981492/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144014437","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 Intra-articular Lipoma of Ankle Joint; A Rare Case Report.","authors":"Dhrushith Etakkepravan Puthanveetil, S D Anilkumar, Arun Joseph Paul, Praveen K Prasannan, Harikrishnan Sajeevkumar","doi":"10.13107/jocr.2025.v15.i04.5432","DOIUrl":"https://doi.org/10.13107/jocr.2025.v15.i04.5432","url":null,"abstract":"<p><strong>Introduction: </strong>Most soft-tissue tumors in the foot and ankle are benign. While lipomas are the most prevalent type of soft-tissue tumor, intra-articular lipomas are exceptionally rare. Most documented intra-articular lipomas involve the knee joint, and there have been only a few case reports of an intra-articular lipoma in the ankle.</p><p><strong>Case report: </strong>We present the case of a 77-year-old woman with a recurrent, progressively enlarging ankle mass that had persisted for 19 years following surgery 15 years prior. At present, the swelling is limiting her range of motion. On examination, a firm, non-tender mass was observed on the medial side of the left ankle joint without any signs of inflammation. The mass was non-compressible, immobile, and did not transilluminate. The clinical diagnosis suggested a soft-tissue ganglion. A radiograph showed soft-tissue opacity over the anteromedial aspect of the tibiotalar joint. Magnetic resonance imaging (MRI) revealed a well-defined, multilobulated, encapsulated lesion at the tibiotalar joint's medial side, with intra- and extra-articular components. The patient underwent surgical excision of the tumor, and histopathological examination confirmed the presence of mature adipose tissue consistent with an intra-articular lipoma with fibrous septa. At the follow-up visit, the patient reported a complete resolution of symptoms and had no further complaints.</p><p><strong>Conclusion: </strong>An intra-articular lipoma of the ankle is an extremely rare tumor. Clinical examination is essential in diagnosing the lesion. MRI is primordial for both differential diagnosis and preoperative planning. Depending on the tumor size, an excision can be performed through open arthrotomy or arthroscopy.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 4","pages":"26-30"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11981504/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144009698","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":"Systemic Sclerosis Presenting as Osteomyelitis of the Finger: Physicians Must Maintain a High Index of Suspicion for Systemic Sclerosis when Evaluating Patients with Fingertip Ulceration or Infection.","authors":"Logan Van Poucke, Jared B Hinton, Holly C Heck, Benjamin E Heck, Bruce E Heck","doi":"10.13107/jocr.2025.v15.i04.5442","DOIUrl":"https://doi.org/10.13107/jocr.2025.v15.i04.5442","url":null,"abstract":"<p><strong>Introduction: </strong>Osteomyelitis is a serious bone infection commonly caused by bacterial pathogens, with Staphylococcus aureus being the most prevalent. The condition poses significant challenges in patients with underlying autoimmune disorders such as scleroderma and Raynaud's syndrome, where vascular dysfunction and immunosuppression heighten infection risks. This case report illustrates the complex interplay between these conditions and underscores the importance of early diagnosis and comprehensive management to prevent severe complications.</p><p><strong>Case report: </strong>We present the case of a 79-year-old female with a history of Raynaud's syndrome and suspected scleroderma who developed osteomyelitis of the left middle finger following a paronychial infection. The patient experienced persistent pain and swelling despite multiple debridement procedures. Physical examination revealed necrosis and gangrene of the affected finger, and magnetic resonance imaging confirmed osteomyelitis. Cultures identified Corynebacterium accolens, an uncommon pathogen in this context. The patient underwent surgical debridement, followed by antibiotic therapy and vasodilators. Her condition improved, with no signs of infection at follow-up.</p><p><strong>Conclusion: </strong>This case highlights the critical need for early and thorough assessment of infections in patients with autoimmune conditions such as scleroderma and Raynaud's syndrome. The vascular dysfunction inherent in these diseases can exacerbate infections, leading to severe outcomes such as osteomyelitis. A multidisciplinary approach involving early surgical intervention and tailored medical management is essential to optimize patient outcomes.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 4","pages":"52-55"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11981491/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144018579","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}