Journal of Orthopaedic Case Reports最新文献

{"title":"Transformative Spinal Surgery: Lateral Position Unilateral Biportal Endoscopic Discectomy.","authors":"Jipin Gopi, Sharafuddeen Mammu, Aarabhy Jayan, Jamshad O P, Fijad N R, Vaisakh Vk","doi":"10.13107/jocr.2025.v15.i01.5128","DOIUrl":"10.13107/jocr.2025.v15.i01.5128","url":null,"abstract":"<p><strong>Introduction: </strong>Endoscopic spine surgery (ESS) is a minimally invasive technique that allows for direct visualization of spinal pathologies and has become a safe and effective alternative to traditional open spine surgery. Conventionally performed in the prone position, biportal endoscopy can also be done in the lateral position to avoid prone-associated complications. To our knowledge, the use of unilateral biportal endoscopy (UBE) in the lateral position has not been previously reported.</p><p><strong>Case report: </strong>We present the case of a 53-year-old male who experienced severe low back pain and right-sided radiculopathy due to a disc protrusion at the L4-L5 level. The patient was managed surgically using UBE in the lateral position once the conservative management was ineffective. This innovative approach aimed to minimize the complications associated with the prone position typically used in such procedures.</p><p><strong>Conclusion: </strong>The successful management of L4-L5 intervertebral disc prolapse using UBE in the lateral position in this case demonstrates the potential of this technique as an effective and minimally invasive alternative to conventional surgical methods. This approach could offer a viable solution for treating degenerative spinal diseases while mitigating the steep learning curve associated with ESS. Further research and clinical studies are necessary to validate and optimize this technique.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 1","pages":"67-72"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11723722/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142971302","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":"Re-arthroscopic Findings 18 Years After Osteochondral Autologous Transplantation for Cartilage Lesion in the Knee: A Case Report.","authors":"Takahiro Maeda, Yasuaki Nakagawa, Shogo Mukai","doi":"10.13107/jocr.2025.v15.i01.5174","DOIUrl":"10.13107/jocr.2025.v15.i01.5174","url":null,"abstract":"<p><strong>Introduction: </strong>Despite the good clinical outcomes of osteochondral autograft transplantation (OAT), reports of re-arthroscopic findings after OAT have been limited to short-term, and there are no reports of findings after long-term follow-up. This is the first report that describes re-arthroscopic findings long-term after OAT.</p><p><strong>Case report: </strong>A male patient underwent OAT on the lateral femoral condyle (LFC) of the knee and lateral meniscus (LM) repair at the age of 45. Eighty years after the primary surgery, he underwent re-arthroscopy because of cartilage injury on the medial femoral condyle (MFC) and LM tear. The re-arthroscopic findings showed the retained OAT plugs on LFC and severe damage of LM. After OAT on the LFC and meniscectomy of LM was performed, his knee symptoms improved, so the LFC that had undergone OAT 18 years previously was considered to be on a good clinical course.</p><p><strong>Conclusion: </strong>OAT plugs were retained at the long-term follow-up while the repaired LM was severely damaged. The structural robustness of OAT was thought to be responsible for good long-term clinical outcomes.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 1","pages":"193-196"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11723742/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142971152","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":"Is there an Increase in Total Hip Arthroplasty Due to Osteonecrosis of Femoral Head After Covid-19 Pandemic?: A Retrospective Study Among Patients in Central Karnataka, India.","authors":"R Aishwarya, Vijayakumar S Kulambi, Subodh B Shetty, Harsh Kirthi Rao","doi":"10.13107/jocr.2025.v15.i01.5190","DOIUrl":"10.13107/jocr.2025.v15.i01.5190","url":null,"abstract":"<p><strong>Introduction: </strong>Coronavirus disease 2019 (COVID-19) infection or corticosteroid usage during the COVID-19 pandemic as risk factors for avascular necrosis (AVN) of the femoral head (osteonecrosis of the femoral head/femoral head AVN [FHAVN]), as well as its link to clinical and radiological outcomes, are poorly understood. Osteonecrosis, which results from a disruption in vascular supply to the femoral head, is a prevalent cause of hip joint deterioration and one of the most common reasons for total hip arthroplasty (THA)/total hip replacement in India and other Asian countries. This study will aid in understanding the condition's epidemiology and statistically determining the risk of disease related with pandemic exposure.</p><p><strong>Materials and methods: </strong>This is a retrospective study of 100 hips diagnosed with osteonecrosis/osteoarthritis of the femoral head that underwent THA at a tertiary care center before and after the COVID-19 pandemic between February 2014 and February 2024.</p><p><strong>Results: </strong>Late stages of FHAVN, when the diagnosis requiring THA, following the pandemic have increased exponentially. It has also switched from affecting the middle-aged to the younger age groups. Furthermore, the bilaterality necessitating THA has increased considerably. There is a clear shift in the presentation of this disabling illness, as well as the need for THA, which otherwise is rarely carried out on younger people. Furthermore, data on how much corticosteroids were used in the treatment is disturbingly scant, and how it may have contributed to this ailment in India is still questionable.</p><p><strong>Conclusion: </strong>The COVID-19 pandemic could be the most serious threat, causing late-stages FHAVN (stages 3 and 4 of the Ficat and Arlet classification), in an accelerated manner, necessitating THA and overburdening existing medical care.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 1","pages":"247-253"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11723729/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142971296","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 Systemic Cystic Angiomatosis in an Elderly Female Initially Misdiagnosed as Vascular Neoplasm: A Case Report and Literature Review.","authors":"Sandeep Mohan, Rahul Krishnan, Sernam Kuttiyil, S Archa, Hamdi Nizar Ahamed, Rashik Ismail","doi":"10.13107/jocr.2025.v15.i01.5104","DOIUrl":"10.13107/jocr.2025.v15.i01.5104","url":null,"abstract":"<p><strong>Introduction: </strong>Systemic cystic angiomatosis is an exceedingly rare condition characterized by widespread cystic vascular lesions involving multiple organs. Its clinical presentation can be non-specific, often leading to diagnostic challenges. This report discusses the case of a 72-year-old female with a long-standing history of diabetes mellitus who presented with non-specific symptoms, ultimately diagnosed with systemic cystic angiomatosis after an initial misdiagnosis of vascular neoplasia. The role of advanced imaging techniques and a multidisciplinary, individualized management approach is emphasized.</p><p><strong>Case report: </strong>A 72-year-old female with long-standing diabetes presented with non-specific symptoms, including fatigue, fever, and rashes on the upper limbs. Initial physical examination revealed anemia and severe thrombocytopenia with a leukoerythroblastic blood picture. Despite unremarkable initial imaging studies, a bone marrow biopsy suggested vascular neoplasia. Further evaluation with a positron emission tomography (PET) scan revealed multiple non-avid lytic skeletal areas and cystic liver lesions, leading to a diagnosis of systemic cystic angiomatosis. A conservative management approach with danazol and eltrombopag was adopted. The patient later developed an acute-on-chronic subdural hematoma, a severe complication of the condition.</p><p><strong>Conclusion: </strong>This case highlights the diagnostic complexity and the necessity for individualized management strategies in systemic cystic angiomatosis. It underscores the importance of considering rare diagnoses when faced with non-specific symptoms and atypical laboratory findings. Advanced imaging techniques, such as PET scans, and a multidisciplinary approach are crucial for accurate diagnosis and effective management of this rare condition.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 1","pages":"8-12"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11723755/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142971232","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":"Atraumatic Bilateral Transcervical Femoral Neck Fractures in an Elderly Epileptic Patient: A Case Report.","authors":"Pratik Tawri, Mansoor Malnas, Parag Munshi","doi":"10.13107/jocr.2025.v15.i01.5156","DOIUrl":"10.13107/jocr.2025.v15.i01.5156","url":null,"abstract":"<p><strong>Introduction: </strong>The occurrence of non-traumatic bilateral femoral neck fractures is exceedingly rare, and their manifestation subsequent to an epileptic attack is an uncommon entity with very few cases reported globally.</p><p><strong>Case report: </strong>We present the positive outcome of a 68-year-old man who underwent staged bilateral constrained total hip arthroplasty following a fracture resulting from a generalized seizure. This unconventional decision was justified based on several factors, including fracture pattern, bone quality, seizure history, and advanced tribology.</p><p><strong>Conclusion: </strong>Epileptic patients pose a potential high risk for hip dislocation or fracture neck of femur. In such cases, we advocate for primary constrained arthroplasties as a viable and durable option, considering the specific circumstances and challenges associated with these patients.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 1","pages":"145-149"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11723763/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142971301","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":"Brachial Plexus Paralysis after Thoracotomy through Median Sternotomy: A New Case Report of Poor Prognosis Despite Lower Radiculopathy.","authors":"Ryunosuke Fukushi","doi":"10.13107/jocr.2025.v15.i01.5132","DOIUrl":"10.13107/jocr.2025.v15.i01.5132","url":null,"abstract":"<p><strong>Introduction: </strong>Thoracotomy through a median sternotomy is considered a risk factor for brachial plexus paralysis. We report a new case of poor prognosis despite lower radiculopathy.</p><p><strong>Case report: </strong>A 53-year-old female (height 152 cm and weight 41 kg) complained of motor impairment in her left fingers, numbness in her left forearm, and paresthesia after left thoracotomy. A descending thoracic aortic replacement (20 mg J-graft 1 branch) had been performed through a left thoracotomy. After the surgery, she noticed movement disorder, numbness, and paresthesia and was referred to an orthopedic surgeon. Vitamin B12 formulation was administered, and she was followed up. The patient recovered motor function 8 months postoperatively, but numbness in the median nerve region remained 18 months after thoracotomy.</p><p><strong>Conclusion: </strong>Even if brachial plexus paralysis persists as lower radiculopathy, nerve compression is relatively more severe in petite patients, suggesting that the prognosis may be poor.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 1","pages":"79-82"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11723739/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142971304","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":"Custom-Made 3D-Printed Augments and Cages: An Effective Solution for Managing Severe Acetabular Bone Loss.","authors":"Adarsh Annapareddy, Vijay C Bose, Ameya Ajit Katariya, Praharsha Mulpur, Tarun Jayakumar, Mujtaba Ansari, Chandan S, A V Gurava Reddy","doi":"10.13107/jocr.2025.v15.i01.5180","DOIUrl":"10.13107/jocr.2025.v15.i01.5180","url":null,"abstract":"<p><strong>Introduction: </strong>Total hip arthroplasty (THA) is recognized as one of the most effective surgical procedures for the treatment of end-stage hip arthritis. However, the increasing number of primary THA cases has led to a corresponding rise in the frequency of revision surgeries, which are often more complex and challenging due to severe acetabular bone loss. In such cases, managing Paprosky type 3A and 3B defects requires precise implant design and advanced surgical techniques. Standard acetabular augments and anti-protrusio cages are commonly used, but they often fail to provide the necessary stability, leading to re-revision rates as high as 36% within 10 years. This case series explores the efficacy of custom-made 3D-printed acetabular augments and cages in managing severe acetabular bone loss during revision THA.</p><p><strong>Materials and methods: </strong>This retrospective case series includes seven patients who underwent revision THA for Paprosky grade 3 acetabular bone loss between January 2023 and April 2024 at two high-volume tertiary care centers. The mean age of the patients was 45 years, with three males and four females included in the study. Pre-operative planning involved advanced imaging techniques, including 3D-computed tomography scans and custom virtual modeling, to design the acetabular components tailored to each patient's specific anatomical requirements.During the surgeries, custom-made 3D-printed titanium augments and cages were used. These implants were fabricated using in-house software, and the turnaround time from the decision to surgery was approximately 10 days. Post-operatively, the planned 3D model was superimposed on post-operative radiographs to assess implant placement accuracy. The Harris hip score at the final follow-up averaged 69.16, with no signs of implant loosening observed.</p><p><strong>Conclusion: </strong>Custom-made 3D-printed acetabular augments and cages offer a reliable and cost-effective solution for managing severe acetabular bone loss in revision THA. Despite the small sample size and short follow-up period, the results demonstrate the potential of these custom implants to improve outcomes in complex acetabular reconstructions. Further studies with larger sample sizes and longer follow-up periods are needed to confirm these findings and establish long-term efficacy.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 1","pages":"208-214"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11723743/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142971324","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":"1-Year Follow-Up Result of Early Definitive Management of the Trauma Patient in a Tertiary Health Care Centre.","authors":"Arvind Vatkar, Sachin Kale, Rohan Jayaram, Ashmit Verma, Saurabh Pandey, Sachiti Kale","doi":"10.13107/jocr.2025.v15.i01.5170","DOIUrl":"10.13107/jocr.2025.v15.i01.5170","url":null,"abstract":"<p><strong>Introduction: </strong>Road traffic accidents (RTA) account for a sizable portion of morbidity and mortality globally, with a particularly high incidence among young and active individuals. Patients presenting with polytrauma require a multidisciplinary approach guided by protocols for advanced trauma life support.</p><p><strong>Case report: </strong>We report the case of a 31-year-old female, transferred-in to our center following primary care after an RTA on June 17th, 2023. Initial assessment at the other hospital found multiple fractures accompanying her internal injuries - a right haemothorax and pulmonary contusion, with Grade 3 injuries to the liver, spleen, and kidneys. The patient, who was also found to be pregnant, presented to our facility with hypotension and breathlessness. Stabilization efforts spanned to include ventilatory support following resuscitation in the intensive care unit. Upon achieving hemodynamic stabilization, early definitive fixation was meticulously planned and implemented, leading to intramedullary nailing of the femur, open reduction and internal fixation in the left wrist, and percutaneous fixation of the right acetabulum. Despite landing in post-operative complications such as pleural effusion and subcutaneous emphysema, the patient showed remarkable recovery and was successfully extubated on June 27th, 2023. She was discharged vitally stable, and continued recovery at her residence. The patient managed to regain full range of motion in all joints, with good union of fractures at the end of her 1-year post-operative follow-up period.</p><p><strong>Conclusion: </strong>This case highlights the importance of tailoring an approach which was unique to the polytrauma presentation. While damage control orthopaedics is often recommended in unstable patients, early definitive orthopedic care must be considered where patients are successfully resuscitated and stabilized, invariably improving trauma outcomes.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 1","pages":"183-188"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11723721/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142971295","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":"Recent Advances in Managing Ankylosing Spondylitis with Andersson Lesion: A Clinical Overview and Case Report.","authors":"Akshay J Kumar, Naveen Sathiyaseelan, J Benjamin Vinodh, Arun Vignesh, Nitesh Kumar Rathi","doi":"10.13107/jocr.2025.v15.i01.5110","DOIUrl":"10.13107/jocr.2025.v15.i01.5110","url":null,"abstract":"<p><strong>Introduction: </strong>Ankylosing spondylitis (AS) is a chronic inflammatory disorder that primarily affects the spine and sacroiliac joints, leading to pain, stiffness, and progressive thoracolumbar kyphotic deformity. A key complication in advanced AS is the development of Andersson lesions (AL), degenerative vertebral lesions resulting from the disease's progression. These lesions can cause significant mechanical pain, often mistaken for the chronic discomfort associated with AS. The exact cause of AL remains unclear, with hypotheses ranging from spinal stress fractures to delays in the ankylosing process. Understanding AL's pathophysiology is essential for timely diagnosis and effective management.</p><p><strong>Case report: </strong>A 52-year-old male presented with a 20-year history of diffuse abdominal pain, later developing insidious lower back pain over the past 2 months. The pain was aggravated by walking and prolonged standing. Physical examination revealed tenderness in the D11 region of the spine, with limited chest expansion and positive findings on the modified Schober's test. Radiographic studies showed irregularities and erosions at the D11-D12 vertebral levels, and magnetic resonance imaging confirmed the presence of an AL associated with asymmetrical bilateral sacroiliitis. The patient tested positive for human leukocyte antigen-B27, supporting a diagnosis of AS with an AL. Medical management, including methotrexate, sulfasalazine, non-steroidal anti-inflammatory drugs, and corticosteroids, led to significant pain reduction and improved mobility. The patient's condition remained stable with continued treatment over a 2-year follow-up period.</p><p><strong>Conclusion: </strong>AL s are chronic, often overlooked complications of AS that can lead to spinal instability and neurological deficits if untreated. Early recognition and management are critical to preventing progressive kyphotic deformities and associated complications. While conservative treatment remains the cornerstone for managing AL, surgical intervention may be required in cases of severe pain, deformity, or neurological involvement. Understanding AL's presentation and treatment options is vital for improving patient outcomes in AS.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 1","pages":"21-25"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11723769/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142971274","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":"Tibial Nerve injury in Medial Open Wedge-High Tibial Osteotomy - A Rare Complication with 14-Year Follow-Up.","authors":"Woon-Hwa Jung, Aniket Wagh, Minseok Seo","doi":"10.13107/jocr.2025.v15.i01.5178","DOIUrl":"10.13107/jocr.2025.v15.i01.5178","url":null,"abstract":"<p><strong>Introduction: </strong>Medial open wedge-high tibial osteotomy (MOW-HTO) is a standard procedure for treating moderate varus arthritis in active adults. The reason for its popularity is having lesser complications than other types of HTO. However, it is not devoid of challenges. We report tibial nerve injury in a MOW-HTO which is a rare complication not reported much in the past.</p><p><strong>Case report: </strong>A 56-year-old female was operated with MOW-HTO using TomoFix plate for medial joint arthritis and varus malalignment. She developed signs of tibial nerve injury, namely inability to flex the great toe and paresthesia over posterolateral leg and sole of foot. The nerve conduction velocity study confirmed tibial nerve damage with moderate axonotmesis. The patient was treated conservatively with electrical stimulation, interferential current therapy, physiotherapy, and pregabalin. The osteotomy outcome was good with complete union and good angle correction. At the end of 14 years, the motor function was fully recovered, but the patient still had residual paresthesia. After eliminating all other possible causes, the authors concluded that the etiology of the nerve damage was stretch injury. Smaller incisions are related to excessive retraction leading to unreasonable stretching of the soft tissues and nerves. To avoid such injuries during MOW-HTO, the authors propose an adequate length of incision along with other steps like subperiosteal Hohmann placement to protect neurovascular structures, flexing the knee during the procedure, maintaining posterior position of the plate, and using proper size screws. The main goal of this study is to make surgeons conscious about this rare but possible complication of MOW-HTO.</p><p><strong>Conclusion: </strong>Surgeons need to be aware about this rare complication in MOW-HTO surgery and should be vigilant in recognizing its post-operative signs.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 1","pages":"202-207"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11723749/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142971286","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}