Orthopedics最新文献

{"title":"Planned Versus Intraoperative Vascular Surgery Consultations in Orthopedic Oncology.","authors":"Dylan J Riley, Zachary R Butler, Samuel Alfonsi, Kayla Kupietzky, Michele Richard, Alan T Blank","doi":"10.3928/01477447-20260423-01","DOIUrl":"10.3928/01477447-20260423-01","url":null,"abstract":"<p><strong>Background and objective: </strong>Orthopedic oncology surgeries frequently involve complex resections where critical neurovascular structures are at risk, and vascular injury can result in severe complications, including functional loss and mortality. Although multidisciplinary vascular collaboration is increasingly recognized as beneficial in oncologic surgery, limited evidence exists regarding optimal timing of vascular surgery consultation in orthopedic oncology. This study evaluated whether preoperative planned consultations improve intraoperative and postoperative outcomes compared to intraoperative consultations.</p><p><strong>Materials and methods: </strong>A retrospective review identified 30 patients who underwent orthopedic oncology surgery requiring vascular surgery involvement between 2015 and 2025 at a single academic institution. Patients were categorized into planned vascular consultations (n = 18) and intraoperative consultations (n = 12). Data collection included demographics, operative details, estimated blood loss (EBL), complications, and type of vascular intervention.</p><p><strong>Results: </strong>The intra-operative consultation group experienced significantly higher median EBL (1,225 mL vs 325 mL, <i>P</i> = .015). Additionally, intraoperative consultations demonstrated trends toward longer operative times (307 vs 185.5 minutes) and higher postoperative complication rates. Infections occurred in 42% of intraoperative cases compared to 17% of planned cases. One intraoperative patient also experienced cardiac arrest, and another developed deep vein thrombosis.</p><p><strong>Conclusion: </strong>Planned vascular surgery consultations are associated with significantly reduced intraoperative blood loss and trend toward improved operative efficiency and fewer postoperative complications. This is the first study directly comparing outcomes between planned and intraoperative vascular consultations in orthopedic oncology. Early vascular involvement enables better anticipation of vascular challenges and supports proactive multidisciplinary collaboration to enhance patient safety and optimize resource use.</p>","PeriodicalId":19631,"journal":{"name":"Orthopedics","volume":"49 3","pages":"e190-e196"},"PeriodicalIF":1.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148043335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Socioeconomic Disadvantage on Patient-reported Outcomes After Orthopedic Trauma: A Study Using the Area Deprivation Index.","authors":"Haley D Puckett, Jacob S Borgida, Rebekah M Kleinsmith, Stephen A Doxey, Riley Swenson, Rachael L Rivard, Sandy Vang, Lauren M Shapiro, Mai P Nguyen, Brian P Cunningham","doi":"10.3928/01477447-20260326-01","DOIUrl":"10.3928/01477447-20260326-01","url":null,"abstract":"<p><strong>Background: </strong>Socioeconomic status (SES) is increasingly recognized as a key factor influencing outcomes after orthopedic procedures. The objective of this study was to determine the effect of socioeconomic disadvantage on patient-reported outcomes (PROs) after orthopedic trauma.</p><p><strong>Materials and methods: </strong>A retrospective review of PROs was performed for orthopedic trauma patients from 2018 to 2023. The Area Deprivation Index (ADI) was used as a surrogate for socioeconomic disadvantage. Outcomes included Patient-Reported Outcomes Measurement Information System Global Physical Health and Global Mental Health 10-item short forms (PROMIS 10 GPH and GMH) at 6 weeks, 3 months, 6 months, and 1 year postoperatively. A mixed-model analysis was performed to compare outcomes among ADI cohorts.</p><p><strong>Results: </strong>In total, 844 patients were included. Of these, 313 (37.1%) were in the least socioeconomically disadvantaged group. There was a significant difference in the distributions of age, marital status, smoking status, and self-reported race among the five ADI cohorts (<i>P</i> < .002). Patients with an ADI of 1 or 2 (low disadvantage) had significantly higher PROMIS 10 GPH scores compared with their counterparts in ADI Groups 3/4, 5/6, and 9/10, although all groups saw a similar significant improvement from the 6-week to 1-year follow-up.</p><p><strong>Conclusion: </strong>Socioeconomic disadvantage has a significant effect on PROMIS 10 GPH and GMH scores following orthopedic trauma procedures. However, patients in all ADI cohorts saw improvements in PROMIS 10 GPH up to 1 year postoperatively. It is important to identify patients in socioeconomically disadvantaged areas and create care pathways to better optimize their improvements postoperatively.</p>","PeriodicalId":19631,"journal":{"name":"Orthopedics","volume":" ","pages":"e213-e222"},"PeriodicalIF":1.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147777779","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Varied Severity of Chronic Kidney Disease Stage on Surgical Outcomes Following Distal Radius Fracture Operative Fixation.","authors":"Joshua G Sanchez, Katie M Zehner, Andrew Salib, Claire A Donnelly, Fortunay H Diatta, F Perry Wilson, Jonathan N Grauer","doi":"10.3928/01477447-20260323-02","DOIUrl":"10.3928/01477447-20260323-02","url":null,"abstract":"<p><strong>Background: </strong>Chronic kidney disease (CKD) alters bone metabolism, immune function, and vascular health, potentially increasing postoperative risk following distal radius fracture (DRF) operative fixation (ie, open reduction and internal fixation, percutaneous pinning). However, data stratifying risk by CKD severity remain limited. This study evaluated the association between CKD stage and 90-day complications and 1-year orthopedic-related events following DRF operative fixation.</p><p><strong>Materials and methods: </strong>Adults aged 18 to 65 undergoing isolated DRF operative fixation were identified in the PearlDiver M170 database. Patients were stratified by CKD status: none, stage 1 to 2, stage 3 to 4, and stage 5 or end-stage renal disease (ESRD). Ninety-day medical complications and 1-year orthopedic-related events were assessed using univariable and multivariable logistic regression controlling for age and sex, with and without adjustment for Elixhauser Comorbidity Index (ECI). Bonferroni correction was significant at <i>P</i> ≤ .001.</p><p><strong>Results: </strong>Among 29,009 patients, 28,411 (97.9%) had no CKD history, 101 (0.3%) had stage 1 to 2 CKD, 336 (1.2%) had stage 3 to 4, and 161 (0.6%) had stage 5/ESRD. Complication risk increased stepwise with CKD severity. Adjusting for age and sex, odds ratios (OR) for any 90-day complication were 5.62, 15.07, and 30.63 for stages 1 to 2, 3 to 4, and 5/ESRD, respectively (all <i>P</i> < .001). After ECI adjustment, associations remained significant, although attenuated (OR = 2.23, 5.93, and 11.04, respectively). No differences were observed in 1-year orthopedic-related events, including hardware removal or malunion/nonunion.</p><p><strong>Conclusion: </strong>CKD independently and incrementally increased short-term complication risk following DRF operative fixation, even after accounting for comorbidity burden. These findings support stage-based perioperative counseling and multidisciplinary optimization in patients with CKD.</p>","PeriodicalId":19631,"journal":{"name":"Orthopedics","volume":" ","pages":"e203-e212"},"PeriodicalIF":1.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147628202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Small Femoral Nails and the Development of a Nonunion: A Case-Control Study.","authors":"Jordan Brand, Meghan Hughes, Kristin E Turner, Joshua E Lawrence, Murali Kovvur, Mark J Gage, Jason W Nascone, Marcus F Sciadini, Nathan N O'Hara, Robert V O'Toole","doi":"10.3928/01477447-20260429-02","DOIUrl":"10.3928/01477447-20260429-02","url":null,"abstract":"<p><strong>Background and objective: </strong>Locked intramedullary (IM) nails are the primary treatment modality for femoral shaft fractures. This study aimed to determine the risk of developing a femur nonunion as a function of nail-to-bone diameter mismatch.</p><p><strong>Materials and methods: </strong>A retrospective case-control study was performed at a Level I trauma center. Adult patients with femoral shaft fractures (AO/OTA 32 classification) treated with IM nail fixation from 2016 to 2022 were identified from the institutional database. Cases required nonunion surgery. Controls were randomly selected in a 3:1 ratio and included only if fractures healed at final follow-up based on the modified Radiographic Union Score of the femur (mRUSF). The primary outcome was nonunion. The study compared the association of nonunion with nail diameter (range, 9 mm to 13 mm) relative to femur width (range, 12 mm to 36 mm) and adjusted for smoking status, open fracture, and the degree of comminution.</p><p><strong>Results: </strong>In total, 203 patients were included: 50 cases and 153 controls. Patients with a femur anterior-to-posterior diameter >22 mm at the level of the lesser trochanter (11% of this sample) were at increased odds for nonunion when treated with a small diameter IM nail (odds ratio [OR], 2.1; 95% confidence interval [CI], 1.2-3.7; <i>P</i> = .01). In patients with narrower femur diameters, the nail diameter was not associated with increased odds of nonunion surgery.</p><p><strong>Conclusion: </strong>Larger IM nails (≥11 mm) might have protected against nonunion in patients with wide femoral canals (≥22 mm) but likely conferred no significant benefit in patients with narrower femoral canals.</p>","PeriodicalId":19631,"journal":{"name":"Orthopedics","volume":"49 3","pages":"e229-e234"},"PeriodicalIF":1.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148043378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Three Cases of Ipsilateral Limb Swelling Secondary to Iliopsoas Bursitis Following Total Hip Arthroplasty.","authors":"Xinyu Na, Chenghao Ren, Tong Chen, Haizhao Wu","doi":"10.3928/01477447-20260323-01","DOIUrl":"10.3928/01477447-20260323-01","url":null,"abstract":"<p><p>This article reports three cases of ipsilateral limb swelling following total hip arthroplasty secondary to vascular compression from iliopsoas bursitis. The etiology was attributed to insufficient acetabular component anteversion, leading to polyethylene liner wear and iliopsoas impingement. Two patients underwent revision surgery and achieved symptom resolution. In contrast, the third patient opted for conservative management, resulting in recurrent limb swelling and the development of deep vein thrombosis. The patient required interventional treatment by the vascular surgery service and ultimately showed clinical improvement.</p>","PeriodicalId":19631,"journal":{"name":"Orthopedics","volume":" ","pages":"e257-e262"},"PeriodicalIF":1.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147628261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Canopy Flap: A Specially Shaped Flap for the Repair of Complex Hand Defects.","authors":"Long-Feng Chen, Zi-Zheng Wang, Wen-Xiong Li","doi":"10.3928/01477447-20260320-01","DOIUrl":"10.3928/01477447-20260320-01","url":null,"abstract":"<p><strong>Background: </strong>Traditional flap transplantation for complex hand defect repair faces challenges like insufficient blood supply and scar contracture. This study aimed to explore the clinical value of the \"canopy flap\" with three-dimensional shaping in such repairs.</p><p><strong>Materials and methods: </strong>A retrospective analysis was conducted on 13 patients with irregular single wounds and complex tissue defects (accompanied by deep tissue exposure and nerve injury) treated with canopy flaps from June 2021 to March 2025. The technique included preoperative wound contour tracing, flap design based on a single perforator vessel, harvesting under tourniquet control, tension-dispersed transfer, microvascular anastomosis, and standardized postoperative management. Follow-up assessments used the British Medical Research Council sensory grading scale and hand function evaluation.</p><p><strong>Results: </strong>Of the 13 flaps, 12 survived completely with primary healing; 1 developed postoperative venous crisis that was successfully salvaged. Follow-up showed flap appearance/texture similar to surrounding skin and no significant scar contracture. Sensory recovery reached S4 (4 cases), S3 (7 cases), and S2 (2 case). Approximately 70% of patients achieved excellent/good hand function, with all donor sites healing without functional impairment.</p><p><strong>Conclusion: </strong>The canopy flap has high survival rate, good three-dimensional conformability, and reduces complications. It achieves favorable sensory and functional recovery, providing a valuable option for complex hand defect repair.</p>","PeriodicalId":19631,"journal":{"name":"Orthopedics","volume":" ","pages":"e263-e268"},"PeriodicalIF":1.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147628211","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aspirin Versus Direct Oral Anticoagulants for Venous Thromboembolism Prophylaxis After Total Knee Arthroplasty: A 10-year Retrospective Cohort Study.","authors":"Regina Chi, Kevin Fox, Brett Ewing, Andrew Nakla, Sean Rajaee","doi":"10.3928/01477447-20260408-01","DOIUrl":"10.3928/01477447-20260408-01","url":null,"abstract":"<p><strong>Background: </strong>Although venous thromboembolism (VTE) prophylaxis has been widely studied, comparative data evaluating aspirin versus direct oral anticoagulants (DOACs) following primary total knee arthroplasty (TKA) remain limited. The study evaluated deep vein thrombosis (DVT) and pulmonary embolism (PE) incidence in patients prescribed aspirin or DOACs.</p><p><strong>Materials and methods: </strong>We retrospectively examined patients undergoing primary TKA at a single academic medical center over a 10-year period. There were 2,232 patients in the aspirin group and 1,638 in the DOAC group. Primary outcome measures include incidence of DVT and PE. A logistic regression model adjusted for differences across groups in relation to the primary outcome measures.</p><p><strong>Results: </strong>The incidence of PEs (0.4% vs 0.6%, <i>P</i> = .486) and DVTs (1.3% vs 1.4%, <i>P</i> = .780) at 90 days were similar between the aspirin and DOAC groups, respectively. After adjusting for significant covariates in the logistic regression model, there remained no differences in the rate of PE and DVT between groups. The incidence of re-operation (0.4% vs 1.0%) was statistically different (<i>P</i> = .009) between the aspirin and DOAC groups at 90 days, respectively.</p><p><strong>Conclusion: </strong>Our study revealed no significant differences in the incidence of PE and DVT among patients receiving either DOACs or aspirin following primary TKA. While the rate of reoperation at 90 days was higher in the DOAC group, no differences were observed at 1 year. This study adds to the growing body of evidence demonstrating the safety and efficacy of aspirin for VTE prophylaxis in TKA.</p>","PeriodicalId":19631,"journal":{"name":"Orthopedics","volume":"49 3","pages":"e184-e189"},"PeriodicalIF":1.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148043392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cauda Equina Dural Sac Hernia Caused by the Drainage Tube After Lumbar Unilateral Biportal Endoscopy Surgery: A Case Report.","authors":"Xiang Fang, Dingjun Xu, Chaowei Lin, Minyu Zhu, Honglin Teng","doi":"10.3928/01477447-20260306-01","DOIUrl":"10.3928/01477447-20260306-01","url":null,"abstract":"<p><p>Previously reported cases of cauda equina herniation primarily involve compression of the spinal cord caused by fracture fragments intruding into the spinal canal following traumatic spinal burst fractures or by dural tears occurring during spinal endoscopic surgery. Such cases can often be evaluated preoperatively or intraoperatively to facilitate the selection of an appropriate treatment plan. However, cauda equina herniation resulting from the use of a drainage tube following spinal endoscopic surgery has not yet been reported. In this article, we present a case of a 76-year-old male patient who experienced a dural tear resulting in cauda equina herniation due to the positioning of the drainage tube following an L4/5 lumbar unilateral biportal endoscopy procedure. This case highlights the importance of timely surgery following cauda equina herniation and provides guidance for intraoperative procedures and perioperative management of patients undergoing spinal endoscopic surgery.</p>","PeriodicalId":19631,"journal":{"name":"Orthopedics","volume":"49 2","pages":"e180-e183"},"PeriodicalIF":1.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147513912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiographic Features of Posttraumatic Knee Osteoarthritis More Than 10 Years After Anterior Cruciate Ligament Reconstruction: Osteophyte Enlargement With Preserved Joint Space.","authors":"Kengo Sugitani, Youngji Kim, Mitsuaki Kubota, Yo Kawashima, Noriaki Mihara, Hitoshi Arita, Jun Tomura, Jun Shiozawa, Shinnosuke Hada, Keiichi Yoshida, Haruka Kaneko, Yoshitomo Saita, Muneaki Ishijima","doi":"10.3928/01477447-20260210-01","DOIUrl":"10.3928/01477447-20260210-01","url":null,"abstract":"<p><strong>Background: </strong>Anterior cruciate ligament (ACL) injury is a major risk factor for knee osteoarthritis (OA). Although ACL reconstruction (ACLR) restores stability, it does not reliably prevent OA. This study investigated the radiographic features of patients with knee OA more than 10 years after ACLR.</p><p><strong>Materials and methods: </strong>Thirty patients (21 female and 9 male; mean age, 45.4 ± 12.0 years) who underwent ACLR more than 10 years ago (mean postoperative period, 14.5 ± 4.0 years) were included. Standing anteroposterior radiographs of ACLR and contralateral healthy knees were evaluated for Kellgren-Lawrence (KL) grade, osteophyte width at the medial and lateral tibial and femoral surfaces, and minimum joint space width (mJSW). Lower limb alignment was assessed using medial proximal tibial angle (MPTA) and joint line convergence angle (JLCA). Subgroup analyses were based on KL grade concordance and history of partial meniscectomy.</p><p><strong>Results: </strong>KL grades were significantly higher in ACLR knees than in contralateral knees (<i>P</i> < .001). Osteophyte widths were greater in ACLR knees at medial tibia (2.1 ± 1.1 mm vs 0.5 ± 0.7 mm), lateral tibia (2.3 ± 2.3 mm vs 0.5 ± 0.7 mm), medial femur (2.0 ± 1.7 mm vs 0.1 ± 0.4 mm), and lateral femur (1.4 ± 2.3 mm vs 0.2 ± 0.5 mm); all <i>P</i> < .001. No significant differences were observed in mJSW (<i>P</i> = .904), MPTA (<i>P</i> = .232), or JLCA (<i>P</i> = .681). Subgroup analyses showed similar findings.</p><p><strong>Conclusion: </strong>Enlarged osteophytes without joint space narrowing were observed in ACLR knees, suggesting a posttraumatic OA radiographic pattern distinct from that of primary OA.</p>","PeriodicalId":19631,"journal":{"name":"Orthopedics","volume":" ","pages":"e114-e121"},"PeriodicalIF":1.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147348827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pediatric Mycobacterium Tuberculosis Infection Involving the Ankle: A Case Report.","authors":"Haiqiong Chen, Shi Gao, Li Li, Xufei Zhao, Guoqiang Zhao","doi":"10.3928/01477447-20260213-01","DOIUrl":"10.3928/01477447-20260213-01","url":null,"abstract":"<p><p>Extrapulmonary tuberculosis is relatively rare, and osteoarticular tuberculosis involving the ankle joint is particularly uncommon. We report a 10.5-year-old, previously healthy male patient who initially presented to the trauma surgery department with a 2-month history of swelling, pain, and limited mobility of the left ankle following minor trauma. Blood tests, including tests to determine blood cell counts, C-reactive protein level, and the erythrocyte sedimentation rate, bacterial and fungal cultures, and T-cell spot tests for tuberculosis (T-SPOT.TB) were performed. B-ultrasound-guided aspiration of the infected area was carried out, which included two surgeries for extensive irrigation, debridement, and drainage. A pus sample was sent for routine bacterial culture and an acid-fast bacillus test, and the bone and soft tissue samples were sent for pathological biopsy and the detection of <i>Mycobacterium tuberculosis</i> by sequencing and rifampicin resistance analysis. The empirical antibiotic was administered for 1 week, followed by linezolid and rifampicin for anti-infection treatment. Ten days later, the T-SPOT.TB test result was positive. Gene sequencing detected the <i>M. tuberculosis</i> complex at \"very low levels\" with no detection of rifampicin resistance, and the pathological report revealed \"chronic necrotizing granulomatous inflammation.\" After the diagnosis of <i>M. tuberculosis</i> infection was confirmed, the patient was started on appropriate antituberculosis therapy with the isoniazid, rifampicin, pyrazinamide, and ethambutol (HRZE) regimen, and the function of the ankle joint was followed up in the outpatient clinic. This case serves as a reminder for clinicians to consider <i>M. tuberculosis</i> infection in children presenting with atypical ankle swelling and pain.</p>","PeriodicalId":19631,"journal":{"name":"Orthopedics","volume":" ","pages":"e167-e171"},"PeriodicalIF":1.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147377328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}