Journal of Orthopaedic Case Reports最新文献

{"title":"Case of Enchondroma of Left 4th Metacarpal of Hand Treated with Excision and Bone Grafting with Left 2nd Metatarsal of Foot: A Rare Case Report.","authors":"Swaroop Solunke, Anup Bansode, Aishwary Verma, Selvi Khajanchi, Setu Kaneria","doi":"10.13107/jocr.2025.v15.i05.5610","DOIUrl":"https://doi.org/10.13107/jocr.2025.v15.i05.5610","url":null,"abstract":"<p><strong>Introduction: </strong>Enchondroma of the hand is a common lesion with a recurrence rate of up to 13.3% after curettage and bone grafting. When hand enchondroma is suspected, less common conditions, such as multiple enchondromatosis syndromes and benign and malignant lesions, should be ruled out. Pathologic fractures often occur. Post-operative complications are typically joint stiffness and soft-tissue-related deformities, whereas recurrence and malignant degeneration of solitary lesions are much less common. Most patients return to full function after surgery.</p><p><strong>Case report: </strong>We present a case of enchondroma of the fourth metacarpal in a 38-year-old female who has a history of a mishap that occurred 3 months ago. Radiographic evaluation was done by X-ray and magnetic resonance imaging which revealed a well-marginated lytic lesion in the head, neck, and distal phalanx of the left 4th finger and significant cortical destruction, completely replacing the bone in the affected region. There was no involvement of the metacarpophalangeal joint. The patient was planned for excision of the 4th metacarpal and bone grafting, plating and K-wire fixation with the 2nd metatarsal bone graft. Post-operatively below elbow slab was given for the patient to promote wound healing and fracture healing for 4 weeks. After 2 weeks of surgery gradual wrist movements were started. Follow-up radiographs were taken every 4 weeks to check for union of bone. Upon radiographic union, finger movement was gradually started as tolerated by the patient. After 8 weeks of surgery radiograph showed a union of bone and K-wires were removed under local anesthesia and full finger movement was started. The patient achieved full finger movement in 12 weeks post-operatively.</p><p><strong>Conclusion: </strong>Enchondroma of the hand has a non-specific clinical presentation and a variable radiographic appearance. A patient-specific differential diagnosis should be established because various benign and malignant processes can mimic enchondroma radiographically. Nevertheless, controversy surrounds the roles of post-curettage surgical adjuncts, immediate versus delayed grafting and fixation, and void management. Surgical management, involving lesion excision and autograft reconstruction, demonstrated excellent results, enabling complete healing and restoration of function within 20 weeks post-operatively. This approach highlights the efficacy of precise surgical techniques combined with structured post-operative rehabilitation in achieving optimal patient outcomes.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 5","pages":"198-203"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12064239/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144004604","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":"Enhancing Orthopedic Residents Learning: The Role of Briefing, Reverse Operative Teaching, and Debriefing.","authors":"Ramy Samargandi","doi":"10.13107/jocr.2025.v15.i05","DOIUrl":"https://doi.org/10.13107/jocr.2025.v15.i05","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of this study is to evaluate the impact of the briefing, reversed operative teaching, and debriefing methods, aiming to enhance the learning process of orthopedic residents in the operating room.</p><p><strong>Materials and methods: </strong>This was a quantitative, cross-sectional study conducted over six months among orthopedic residents. A novel pedagogical model incorporating briefing, reverse operative teaching, and debriefing was implemented and compared to traditional methods. A structured validated questionnaire was used to evaluate the residents' perceptions and satisfaction. Data were analyzed using descriptive statistics.</p><p><strong>Results: </strong>A total of 16 orthopedic residents participated in the study, including eight junior and eight senior residents. The majority reported high levels of satisfaction with the new teaching approach. Key benefits included improved engagement, enhanced knowledge retention, and better mastery of surgical procedures. Residents also noted clearer guidance from senior surgeons, increased confidence in asking questions, and more efficient preparation using targeted educational resources. Most participants expressed a desire to adopt this method in their future teaching roles.</p><p><strong>Conclusion: </strong>The novel teaching method showed promising results and could be beneficial for the training of orthopedic residents.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 5","pages":"218-225"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12064246/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144000712","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":"The Combination Strategy of the Drainage and Resection under the Microendoscope for Giant Discal Cyst: A Case Report.","authors":"Takuhei Kozaki, Takahiro Kozaki, Hiroshi Yamada","doi":"10.13107/jocr.2025.v15.i05.5582","DOIUrl":"https://doi.org/10.13107/jocr.2025.v15.i05.5582","url":null,"abstract":"<p><strong>Introduction: </strong>Discal cysts have been reported as intraspinal extradural cysts connected with corresponding intervertebral discs. The resection of the discal cyst has illustrated the good result. However, we report a much larger discal cyst, which was seemed to be difficult to resect all of them under the microendoscope safety.</p><p><strong>Case report: </strong>A 21-year-old man had experienced pain in the right lower limb for at least a month and was diagnosed with radiculopathy of the right S1 nerve root. Magnetic resonance image showed that mild disc degeneration and cyst at L5/S1, which was measured 12.0 mm on the sagittal view, accounted for 71.1% of the sagittal diameter of the spinal canal. He underwent hemi-flavectomy and the resection of the cyst under the microendoscope. During surgery, we found that there was not enough space in the epidural to remove the cyst safety without the laminectomy. The right S1 nerve root was strongly pushed to the dorsal side, adhered, and stretched by the cyst. First, we have tried to drain the liquid context of the cyst and decrease the volume to make the enough epidural space to perform the surgical procedure safety. Second, we resected the wall, which procedure made the nerve root loosen.</p><p><strong>Conclusion: </strong>The combination of the drainage and resection under the microendoscope has ability to secure the enough working space, prevent the nerve root injury, and minimize the surgical invasion. This strategy can expand the surgical indication for the larger cystic lesion, which have been performed by the open surgery so far.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 5","pages":"128-131"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12064224/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143970555","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 Report Of Incidental Distal Ulna Giant Cell Tumour Presented As Distal Ulna Fracture.","authors":"Rohit Karthik, Vijay Narasimman Reddy, Subramanya Gandhi, Rajlaxmi Reddy","doi":"10.13107/jocr.2025.v15.i05.5606","DOIUrl":"https://doi.org/10.13107/jocr.2025.v15.i05.5606","url":null,"abstract":"<p><strong>Introduction: </strong>Giant cell tumour of ulna is a rare and benign neoplasm but is locally invasive tumour. Distal ulna giant cell tumors have a reported incidence of 0.45 to 0.6%.</p><p><strong>Case report: </strong>43 years old female came with alleged History of slip and fall at her residence sustaining injury to right wrist and suspected to be a giant cell tumor. The giant cell tumour was treated with en bloc resection and curettage (Darrach's procedure). Patient was followed up for 6 months during which she regained full range of motion.</p><p><strong>Conclusion: </strong>Giant cell tumor can masquerade as pathological fracture with En bloc Resection dramatically reducing the risk of recurrence.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 5","pages":"184-189"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12064234/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144005601","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":"Temporal Patterns of Trauma Mortality and Causes of Death in a Level 1 Trauma Center: Implications for Improved Trauma Care.","authors":"Rahul Sreenivasan Thokaloath, Shajimon Samuel, B P Vinod Kumar","doi":"10.13107/jocr.2025.v15.i05","DOIUrl":"https://doi.org/10.13107/jocr.2025.v15.i05","url":null,"abstract":"<p><strong>Introduction: </strong>Trauma mortality patterns have evolved over time, with distinct phases of immediate, early, and late deaths. Advances in trauma care and changing injury dynamics have contributed to shifts in this pattern. Understanding the causes and timing of trauma deaths is pivotal for enhancing trauma care systems.</p><p><strong>Materials and methods: </strong>We conducted a retrospective analysis of trauma deaths in 2020-2022 at a level 1 trauma center. Trauma death data were collected from case records, wound certificates, and death certificates. The time of death from trauma was calculated and deaths were categorized into immediate, early (within 24 h), and late (after 24 h) groups. Statistical analyses, including Chi-square tests, were performed to assess associations.</p><p><strong>Results: </strong>Of the 186 trauma deaths studied, 86.6% were males, and the mean age was 40 ± 16.91 years. Immediate deaths were predominantly due to brain injury (BI) (54.8%), thoracic injury (17.9%), and spinal cord injury (16.7%). Early deaths were mainly attributed to BI (35.1%) and poly-trauma (35.1%). Late deaths (after 24 h) were primarily a result of multiple organ failure (44.4%) and sepsis (24.4%). The analysis showed a significant association between the cause of death and time from trauma to death (P < 0.001).</p><p><strong>Conclusion: </strong>BI emerged as the leading cause of trauma-related deaths, with a progressive decline pattern observed in a well-established trauma care center. Immediate deaths can potentially be reduced through trauma prevention strategies, particularly in the context of high-speed vehicles and machinery. These findings underscore the importance of timely interventions, effective critical care, and continuous improvements in trauma care systems.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 5","pages":"240-247"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12064228/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144022739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Novel Variant of Suprascapular Neurovascular Morphology: Clinical and Surgical Implications.","authors":"Jordan Konstanty, Robert J Heins, Nicholas Donohue, Bryan G Beutel","doi":"10.13107/jocr.2025.v15.i05.5594","DOIUrl":"https://doi.org/10.13107/jocr.2025.v15.i05.5594","url":null,"abstract":"<p><strong>Introduction: </strong>The suprascapular neurovascular structures traverse the suprascapular notch in a variety of morphologies. However, the suprascapular nerve has always been described as coursing under the superior transverse scapular ligament (STSL) at the level of the notch. This report aims to describe a novel variant of suprascapular neurovascular structures found in a cadaver.</p><p><strong>Case report: </strong>During the dissection of a cadaveric upper extremity in an 85-year-old Caucasian male, the suprascapular nerve, artery, and vein were found to course above the STSL, with no structures passing through the foramen of the notch itself. A total of 94 upper extremities from 52 different cadavers were subsequently examined for the morphology of the suprascapular nerve, artery, and vein at the level of the suprascapular notch. No other cadavers were found to have this morphology, thereby resulting in an estimated prevalence of 1.1%.</p><p><strong>Conclusion: </strong>This case study describes this unique unilateral shoulder anomaly, reviews the relevant literature, and discusses the potential clinical significance of this variant, which should be considered during various posterior shoulder surgeries or peripheral nerve blocks wherein aberrant morphology can increase the risk of neurovascular complications.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 5","pages":"156-160"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12064265/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144016291","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":"Trimalleolar Fracture of the Bilateral Ankles: A Rare Case Report.","authors":"Sahil D Kale, Sumit Saurabh, Ravi Jatti, Sachin Kale, Arvind Vatkar","doi":"10.13107/jocr.2025.v15.i05.5578","DOIUrl":"https://doi.org/10.13107/jocr.2025.v15.i05.5578","url":null,"abstract":"<p><strong>Introduction: </strong>Ankle fractures are the second most common lower limb fracture after hip fractures. The injuries occur under a variety of conditions such as falls, sports, and road traffic accidents irrespective of age and sex. We report a rare case of trimalleolar fracture of bilateral ankles.</p><p><strong>Case report: </strong>A 20-year-old girl came to casualty with an alleged history of falling from height in December 2023. After which she sustained injuries over her both ankle joints with no history of any head injury. The patient was examined clinically and radiologically. She was diagnosed with a bilateral trimalleolar fracture. The patient underwent bilateral open reduction and internal fixation of the ankle fractures. The procedures were performed sequentially in a staged procedure. The postoperatively patient was followed up for 1 year.</p><p><strong>Conclusion: </strong>This case highlights the management and outcome of bilateral ankle trimalleolar fractures, which is one of the rare cases, following a traumatic fall. Multidisciplinary care is essential for achieving optimal outcomes and ensuring an early return to function for patients with such injuries.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 5","pages":"119-122"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12064261/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143976728","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":"Atypical Presentation of Behcet's Disease with Atlanto Axial Joint Pain as Initial Presentation-A Case Report.","authors":"Sl Sujitha Reddy, B Sathish Pai, N Shyamasunder Bhat, Kanthilatha Pai","doi":"10.13107/jocr.2025.v15.i05.5538","DOIUrl":"https://doi.org/10.13107/jocr.2025.v15.i05.5538","url":null,"abstract":"<p><strong>Introduction: </strong>Behcet's disease (BD) is a chronic and multi-systemic disorder with inflammatory characteristics. It is manifested by recurrent oral aphthae, skin lesions, ocular disease, gastrointestinal involvement, neurological disorders, and vascular disease. Arthritis is seen in half of the patients. However, it rarely affects the spinal column, and patients presenting with neck pain have been reported only in one case in the literature.</p><p><strong>Case report: </strong>Here we report a case of 39 year old male patient with BD whose primary symptom was neck pain. Anti-tubercular therapy was started empirically suspecting cervical tuberculosis. He was further evaluated as he was also developing skin and oral lesions. He was diagnosed to be having Behcet's disease and was started on colchicine, with which both his skin lesions and neck pain improved symptomatically.</p><p><strong>Conclusion: </strong>This case emphasizes that despite atlanto-axial joint pain is a rare manifestation of BD, clinicians should suspect it a differential diagnosis in patients with neck joint pain along with mucous or cutaneous lesions. Accurate diagnosis and early management have to be done to prevent further joint dislocation and associated fatalities.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 5","pages":"16-19"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12064258/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143970433","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":"Simultaneous Bilateral Patellar Tendon Ruptures Treated with Primary Repair and Dermal Allograft Augmentation: A Case Report.","authors":"Tyler Small, Michael Reen, Kyle Mahoney, Karl Siebuhr","doi":"10.13107/jocr.2025.v15.i05.5548","DOIUrl":"https://doi.org/10.13107/jocr.2025.v15.i05.5548","url":null,"abstract":"<p><strong>Introduction: </strong>Patellar tendon ruptures are a relatively common injury encountered by orthopedic surgeons and typically only occur unilaterally. However, there are rare reports of bilateral patellar tendon ruptures occurring simultaneously, in patients with underlying systemic disorders, higher energy mechanisms, or injury or overuse in high-level athletes. When patellar tendon ruptures occur, and the extensor mechanism is disrupted, patellar tendon repair versus reconstruction is warranted to restore functionality. The use of dermal allografts for the reconstruction of chronic patellar tendon ruptures is well described; however, there is not much literature describing their use in the acute setting. This report describes the primary repair of simultaneous bilateral patellar tendon rupture with the use of the ArthroFLEX Decellularized Dermal Allograft. This is a novel use for this allograft, as it is currently indicated for use in the treatment of various tendon repairs/reconstructions as well as hallux rigidus and hip capsule reconstruction. There are no reports describing the use of the ArthroFLEX Decellularized Dermal Allograft in the acute setting as augmentation of primary patellar tendon repair in a patient with simultaneous bilateral patellar tendon ruptures in the absence of underlying systemic disease; thus, this report presents a novel use for this dermal allograft.</p><p><strong>Case report: </strong>This patient is a 40-year-old African American male with no active underlying systemic diagnosis who sustained simultaneous bilateral patellar tendon ruptures from a low-energy mechanism. He subsequently underwent bilateral patellar tendon repair during which a dermal allograft augment was utilized to further strengthen this repair. In addition, a defunctioning purse string suture was used to further protect the patellar tendon repair by off loading the extensor mechanism.</p><p><strong>Conclusion: </strong>This report adds to the body of literature surrounding the rare entity of simultaneous bilateral patellar tendon ruptures in otherwise healthy patients while also presenting a novel use for the ArthroFLEX Decellularized Dermal Allograft in the acute repair of a patellar tendon rupture. This report also supports the use of a defunctioning purse string suture to help offload the healing extensor and decrease the amount of tension across a healing tendon repair.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 5","pages":"37-42"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12064259/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144012296","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":"Talus with Trimalleolar Fracture: A Three-planar Injury of Ankle Joint Complex: A Unique Case Report.","authors":"Santanu Kar, A S Pon Aravindhan, Ritvik Janardhanan, Nitish Jagdish Jyoti, Vijay Sharma, Madhan Jeyaraman","doi":"10.13107/jocr.2025.v15.i05.5586","DOIUrl":"https://doi.org/10.13107/jocr.2025.v15.i05.5586","url":null,"abstract":"<p><strong>Introduction: </strong>Malleolar fractures are common, often bimalleolar/trimalleolar. Talus fractures are rare, with risks like avascular necrosis (AVN). Unique challenges arise, especially in combined injuries, sometimes needing ankle arthrodesis.</p><p><strong>Case report: </strong>An 18-year-old male laborer presented with a history of fall from height and sustained injury over the right ankle. Imaging showed a talar body fracture with a trimalleolar fracture on the same ankle. After the subsidence of swelling at 9 days, the patient underwent open reduction and internal fixation using screws and plates for malleolar fracture and Herbert screw for talus fracture. At 1-year follow-up, the patient had adequate range of motion of the ankle which was painless without any signs of AVN. The patient underwent ankle arthrodesis at 5 years old as he developed severe pain in the joint. After 1 year of arthrodesis, the patient has pain-free motion of the ankle joint.</p><p><strong>Conclusion: </strong>Such fractures are rare with a unique mechanism of injury. There are chances of arthritis and instability owing to the variable cartilage damage and occult ligament injury. Stress radiographs after fracture union can help predict ankle instability. Internal fixation is the method of treatment in the acute setting, though the chances of late arthritis are high.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 5","pages":"136-140"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12064227/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143972357","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}