Journal of Orthopaedic Case Reports最新文献

{"title":"Isolated Distal Radioulnar Joint Dislocation in an Adolescent: A Case Report and Systematic Review.","authors":"Stephen Murphy, Eoin Fahey, Pat Fleming","doi":"10.13107/jocr.2025.v15.i05.5540","DOIUrl":"https://doi.org/10.13107/jocr.2025.v15.i05.5540","url":null,"abstract":"<p><strong>Introduction: </strong>Isolated distal radioulnar joint (DRUJ) dislocation is a rare injury, often presenting following direct trauma with difficulty in active and passive pronation/supination. Accurate and prompt diagnosis is to essential to correctly treat and avoid long-term complications such as pain, stiffness, and loss of function.</p><p><strong>Case report: </strong>We present the case of a 16-year-old male with an acute isolated DRUJ dislocation following a sporting injury. The patient was referred to our major trauma center from a tertiary orthopaedic unit following failed closed reduction (CR). Successful CR was performed in our department. Temporary casting and early rehab with physiotherapy gave the patient good functional results with full recovery at 3 months.</p><p><strong>Conclusion: </strong>Careful history and examination, as well as appropriate imaging, including true anterioposterior and lateral radiographs +/- computed tomography or magnetic resonance imaging, is need to accurately diagnosis this injury. Consider this injury in a patient with difficulty in supination/pronation with reported wrist pain following trauma.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 5","pages":"20-24"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12064266/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144024235","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 Decision-Making in Thoracolumbar Fractures: A Systematic Review of Anterior and Posterior Approach.","authors":"Shekhar Mishra, Pankaj Kumar Mishra, Virendra Kumar Verma, Mohit Issrani, Swasti Sundar Prasad, Vishwakarma C Hodigere","doi":"10.13107/jocr.2025.v15.i05.5612","DOIUrl":"https://doi.org/10.13107/jocr.2025.v15.i05.5612","url":null,"abstract":"<p><strong>Introduction: </strong>Fractures in the thoracolumbar region of the vertebral column are very common and often require surgical intervention. Surgery is typically aimed at restoring or maintaining neurological function and correction of the vertebral column.</p><p><strong>Systematic review: </strong>There are two commonly used approaches for surgery, the anterior and the posterior approach. Uncertainties remain regarding the best surgical approach for the treatment of traumatic thoracolumbar fractures. The results of studies comparing the anterior and posterior surgical approaches for treating thoraco-lumbar fractures have been compiled in this review. Numerous metrics, including neurological results, Cobb angle recovery, and post-operative complications, have been used. It was observed that both approaches yielded a similar result when considering the improvement in Frankel grades and recovery of the Cobb angle.</p><p><strong>Conclusion: </strong>We further report that patients undergoing decompression using the anterior approach incurred higher blood loss, longer hospital stays, and higher operating costs; these findings support the posterior approach as being safer and more practical.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 5","pages":"204-211"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12064250/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143970437","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":"Fibrous Dysplasia in Humerus Shaft - Fixation or Curettage?: A Case Report.","authors":"Aman Rai, J K Giriraj Harshvardhan, Sundar Suryakumar, C Sitsabesan, M Mohd Tavfiq","doi":"10.13107/jocr.2025.v15.i05.5552","DOIUrl":"https://doi.org/10.13107/jocr.2025.v15.i05.5552","url":null,"abstract":"<p><strong>Introduction: </strong>Fibrous dysplasia is a benign skeletal condition characterized by abnormal osteoblastic differentiation and maturation, typically affecting the lower extremity and craniofacial skeleton. It usually manifests in the first three decades of life, with symptoms starting in early childhood. Radiologically, it appears as an expansile, lytic, intramedullary, diaphyseal, or metaphyseal lesion. Treatment options include nonsurgical surveillance, pharmacotherapy, and surgery. Bisphosphonates can manage painless lesions, whereas surgery is necessary for pathological fractures. Alternative treatments include curettage, bone grafting, and internal fixation.</p><p><strong>Case report: </strong>A 24-year-old woman experienced pain in her right arm for 3 years, which had worsened over the past 3 months and was accompanied by swelling for 2 months. The pain was insidious, gradually progressive, and diffuse over the diaphyseal region of the humerus. Examination revealed bony swelling and thickening, restricted shoulder movement and no distal neurovascular deficit.Radiologically, there was an expansile lytic lesion involving the middle and distal third of the diaphysis of the right humerus, suggesting pathological fractures. A magnetic resonance imaging scan revealed an expansile intramedullary lesion involving almost the entire shaft of the right humerus, sparing the proximal metaphyseal region. Histopathological examination revealed hemorrhagic giant cells with fibroblastic proliferation, with no signs of malignancy. Intramedullary fixation was performed with an intramedullary interlocking nail. She began gentle shoulder range-of-motion exercises and pendulum exercises. The patient experienced significant pain relief with good functional outcome and signs of fracture healing.</p><p><strong>Conclusion: </strong>Long bones with fibrous dysplasia that manifest as pathological fractures may be painful and have limited mobility. The fracture can heal, pain can be reduced, and the functional range of motion can be restored by stabilizing the lesion with an intramedullary implant without curettage or bone grafting.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 5","pages":"50-55"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12064243/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143997691","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":"Patellar Osteoid Osteoma: A Rare Cause for Anterior Knee Pain.","authors":"Sushruth Jagadish, Amaresh Cadapa Prahallad, Harshavardhan Bhaktharahalli Ramachandra, Nanjunda Kumar","doi":"10.13107/jocr.2025.v15.i05.5542","DOIUrl":"https://doi.org/10.13107/jocr.2025.v15.i05.5542","url":null,"abstract":"<p><strong>Introduction: </strong>Osteoid osteoma is a benign osteoblastic lesion occurring in the diaphysis of the long bones most commonly. Patellar osteoid osteoma is very rare and most commonly associated with anterior knee pain.</p><p><strong>Case report: </strong>A 21-year-old male presenting with anterior knee pain was diagnosed to have patellar osteoid osteoma after 4 years of onset of symptoms and was treated with radiofrequency ablation. One year following the ablation patient remains pain-free and has a complete range of movements.</p><p><strong>Conclusion: </strong>Atypical location of the tumor makes it difficult to diagnose resulting in delayed management. Hence, it is important to have patellar osteoid osteoma as one of the differential diagnosis in patients having chronic anterior knee pain. Radiofrequency ablation is a novel and minimally invasive procedure for the treatment of Patellar Osteoid Osteoma which can help in resolution of anterior knee pain.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 5","pages":"25-28"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12064223/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143997961","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":"Rise of Revision Arthroplasties in Indian Subcontinent: An Inadvertent Future.","authors":"Kunal Aneja, Supreet Bajwa, Ashok Shyam","doi":"10.13107/jocr.2025.v15.i05.5532","DOIUrl":"https://doi.org/10.13107/jocr.2025.v15.i05.5532","url":null,"abstract":"","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 5","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12064231/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143976549","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":"Understanding the Levels of Evidence in Medical Research.","authors":"Arvind Vatkar, Sachin Kale, Ashok Shyam, Sushant Srivastava","doi":"10.13107/jocr.2025.v15.i05.5534","DOIUrl":"https://doi.org/10.13107/jocr.2025.v15.i05.5534","url":null,"abstract":"<p><p>The advancement of evidence-based medicine (EBM) depends on the evidence hierarchy, a framework for classifying research approaches according to their dependability and quality. It dates back to the middle of the 20th century and classifies techniques such as expert opinions, case reports, randomized controlled trials, and systematic reviews. However, problems such as prejudice and moral constraints still exist. Evidence paradigms are being redefined by emerging technologies such as artificial intelligence, big data, and real-world data. This calls for dynamic hierarchies that include many forms of evidence. High-quality data are essential for developing flexible frameworks for contemporary medicine and influencing clinical guidelines, public health regulations, and educational initiatives.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 5","pages":"6-9"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12064251/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143976818","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":"Burkholderia pseudomallei-induced Oligoarticular Septic Arthritis Masquerading as Tuberculosis in a Non-Diabetic Host from Northern Kerala.","authors":"Ramesh Govindharaaju, Raju Karuppal, Khayas Omer Kunheen, Anand Leo George, A Salmanul Faris","doi":"10.13107/jocr.2025.v15.i05.5560","DOIUrl":"https://doi.org/10.13107/jocr.2025.v15.i05.5560","url":null,"abstract":"<p><strong>Introduction: </strong>Burkholderia pseudomallei, the causative agent of melioidosis, is endemic in tropical and subtropical regions, primarily in Southeast Asia and northern Australia. Cases of septic arthritis caused by B. pseudomallei in India have rarely been reported and have been described mostly in diabetic patients. This case report outlines a case of oligoarticular septic arthritis in a non-diabetic patient with a previous history of extrapulmonary tuberculosis (TB).</p><p><strong>Case report: </strong>A 62-year-old non-diabetic male receiving anti-tubercular therapy (ATT) for tubercular lymphadenitis presented with complaints of painful swelling of his left knee and right shoulder. Before consulting with us, he had undergone an arthrotomy and biopsy of his left knee at a different center. The biopsy was suggestive of granulomatous inflammation with negative cultures and acid-fast bacillus, for which he was advised to continue ATT for an extended duration. ATT did not improve his symptoms, and the patient developed a gradually progressing painful swelling of his right shoulder. At this point, he presented to us. Fresh cultures revealed B. pseudomallei as the causative organism. A strict regimen of intravenous ceftazidime followed by oral cotrimoxazole resulted in gradual recovery.</p><p><strong>Conclusion: </strong>Cases of B. pseudomallei-induced infective arthritis and systemic melioidosis are now being identified in India, probably as a result of increased cross-country travel. This case report describes oligoarticular septic arthritis in a non-diabetic patient, which is unique among similar cases in the literature. A previous history of TB and negative routine cultures confounded the diagnosis.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 5","pages":"70-74"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12064257/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144016293","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":"Synovial Hemangioma of Knee in 4-Year-Old Girl Child - A Case Report.","authors":"Gajanan Kishor Deshmukh, Uday Prabhakar Phute, Dipak Bhimrao Bhange","doi":"10.13107/jocr.2025.v15.i05.5596","DOIUrl":"https://doi.org/10.13107/jocr.2025.v15.i05.5596","url":null,"abstract":"<p><strong>Introduction: </strong>Synovial hemangioma of the knee is rare in children. It was first described in history by Bouchut in 1856 [1]. Hemangioma in children is difficult to diagnose, and chances of missing diagnosis are frequent. It is essential to treat hemangioma early, as delayed treatment can result in joint destruction and arthrosis.</p><p><strong>Case report: </strong>We discuss the case report of a 4-year-old girl with non-traumatic recurrent knee swelling since 6 months previous episode 7 days back. The patient was previously treated with aspiration and a short course of antibiotics, magnetic resonance imaging (MRI) s/o synovitis; we opted for open excision of mass. On follow-up, the patient was completely disease-free.</p><p><strong>Conclusion: </strong>Synovial hemangioma is difficult to diagnose in children, a high index of suspicion is required, MRI is an investigation of choice, and open or arthroscopic excision is the treatment of choice.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 5","pages":"161-164"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12064269/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144063602","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":"Perioperative Considerations for a Patient with Juvenile Idiopathic Scoliosis and Kaposiform Lymphangiomatosis Undergoing Spinal Fusion: A Case Report.","authors":"John P Avendano, Raisa Rauf, Barbara Vickers, Anisha Tyagi, Paul D Sponseller, Joann B Hunsberger","doi":"10.13107/jocr.2025.v15.i05.5572","DOIUrl":"https://doi.org/10.13107/jocr.2025.v15.i05.5572","url":null,"abstract":"<p><strong>Introduction: </strong>Kaposiform lymphangiomatosis is a lymphatic anomaly that, when symptomatic, presents in children at a median age of 6.5 years. Symptoms may include respiratory issues, palpable masses, and hemostatic abnormalities. Kaposiform lymphangiomatosis can be life-threatening due to diffuse tissue expansion and subsequent invasion of surrounding organs and tissues. Initial detection of this rare condition can be difficult due to the varied nature of its presenting symptoms and the overall lack of familiarity of clinicians with the condition. Consequently, misdiagnoses can occur, such as pneumonia, cancer, or other vascular anomalies. When considering operative treatment in patients with kaposiform lymphangiomatosis, meticulous pre-operative planning and multidisciplinary care are required due to the high risks of morbidity and death from blood loss. To the best of our knowledge, this is the first reported case of kaposiform lymphangiomatosis in a patient with juvenile idiopathic scoliosis.</p><p><strong>Case report: </strong>We present the case of a 13-year-old boy diagnosed with kaposiform lymphangiomatosis at age 8 who, after being followed for several years in our orthopedic clinic for worsening juvenile idiopathic scoliosis despite brace wear, underwent posterior spinal fusion with minimal complications (i.e.., minor cerebrospinal fluid leak). The patient had also been followed for several years before his kaposiform lymphangiomatosis diagnosis for unexplained thrombocytopenia, fatigue, and joint pain. Interdisciplinary care involved multiple specialist teams to choose appropriate pre-operative medications, induction protocol, and bone graft.</p><p><strong>Conclusion: </strong>Successful operative treatment in a patient with kaposiform lymphangiomatosis can be achieved with the involvement of an interdisciplinary team, anticipation and preparation for cardiac and pulmonary complications via chest tubes and pericardial windows, setting goal parameters to guide intraoperative monitoring, and ceasing medications such as sirolimus to prevent wound-related complications. Given the lack of a current standard of care for managing patients with kaposiform lymphangiomatosis who have spinal deformity, this report can serve as a guide that sets a benchmark for the management of similar cases.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 5","pages":"103-108"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12064260/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144025612","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":"Challenging Case of Sitting Imbalance as an Indication of Surgery for Grotesque Congenital Deformity of Spine - A Case Report.","authors":"Jeevan Kumar Sharma, Kalidindi Kalyan Kumar Varma, Abhinandan Reddy Mallepally, Padmini Yadav, Arun Sharma, Gururaj Mallikarjun Sangodimath","doi":"10.13107/jocr.2025.v15.i05.5558","DOIUrl":"https://doi.org/10.13107/jocr.2025.v15.i05.5558","url":null,"abstract":"<p><strong>Introduction: </strong>Sitting imbalance due to spinal deformity as an indication of surgery is very rarely encountered.</p><p><strong>Case report: </strong>We came across a very peculiar case of spinal deformity case who was wandering in search of treatment around multiple centers. The main concern for this 16-year-old boy from Yemen, who was born with congenital deformity with myelomeningocele and paraplegia, was sitting imbalance, which developed 2 months before presentation to our institute. Patient underwent a thorough clinical, radiological and multimodality assessment. Staged procedure of diastematomyelia excision followed by definitive posterior deformity correction was performed. Postoperatively, the patient's sitting balance was restored with no complications.</p><p><strong>Conclusion: </strong>Sitting imbalance can be an indication of surgery with congenital complicated kyphoscoliosis. With proper planning and staged management, the sitting balance could be achieved.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 5","pages":"65-69"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12064245/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029953","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}