Case Reports in Orthopedics最新文献

{"title":"Peri-Implant Subcapital Femur Fracture Post Cephalomedullary Nail Fixation.","authors":"Oisin O Connor, Orla Hennessy, Brendan O Daly","doi":"10.1155/cro/4761266","DOIUrl":"10.1155/cro/4761266","url":null,"abstract":"<p><p><b>Presentation:</b> A 65-year-old female with a prior right-sided cephalomedullary nail fixation for a pertrochanteric neck of femur fracture fell from a gate onto her right hip. She was unable to weight-bear on her right leg and presented to the emergency department. <b>Diagnosis:</b> X-ray imaging in the emergency department diagnosed a peri-implant subcapital neck of femur fracture at the base of the lag screw threads. <b>Treatment:</b> After evaluation of multiple treatment options, the patient was managed conservatively with physiotherapy, progressive weight-bearing and bone protection interventions. <b>Discussion:</b> An unusual case of a peri-implant femoral neck fracture that is not well described by current classification systems is presented. This case presents interesting questions in the management of a rare complication of cephalomedullary nailing.</p>","PeriodicalId":30287,"journal":{"name":"Case Reports in Orthopedics","volume":"2026 ","pages":"4761266"},"PeriodicalIF":0.4,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13535851/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148881287","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":"Isolated Posterior Horn Medial Meniscus Bony Avulsion: A Case Report.","authors":"Ahmad R Alhankawi, M Lane Moore, Don L Dulle, Matthew B Anastasi, Anikar Chhabra","doi":"10.1155/cro/7859802","DOIUrl":"10.1155/cro/7859802","url":null,"abstract":"<p><strong>Background: </strong>The menisci provide mechanical stability and shock absorption in the knee joint, distributing stress across the tibial plateau. Root tears to the menisci are functionally equivalent to a total meniscectomy, frequently leading to rapidly progressive degenerative osteoarthritis within the knee joint. The majority of medial meniscal bony avulsions have been reported in younger, skeletally immature patients. Cases of bony avulsions in older patients have sparsely documented.</p><p><strong>Care presentation: </strong>In this case report, we highlight the case of a 45-year-old male with a history of osteoporosis who sustained a twisting injury to the right knee which subsequently resulted in a bony avulsion injury of his medial meniscal root. MRI imaging was acquired, showing injury to the medial meniscus concurrent with an avulsion of the posterior root. A transtibial pullout repair was performed, anchoring the bony avulsion into its insertion site to allow for direct bone-to-bone healing.</p><p><strong>Conclusion: </strong>This case presents a unique mechanism of injury, as most medial meniscal root injuries in older patients involve a tear of the root rather than avulsion of the bone. Additionally, meniscal bony avulsions have been reported to mainly be a consequence of acute traumatic injury. We hypothesize that this patient's history of osteoporosis contributed to his bony avulsion, especially because of his age and his relatively nontraumatic mechanism of injury.</p>","PeriodicalId":30287,"journal":{"name":"Case Reports in Orthopedics","volume":"2026 ","pages":"7859802"},"PeriodicalIF":0.4,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13535856/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148881925","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":"Giant Fibrous Dysplasia of the Sixth Rib Managed in a Rural, Resource-Limited Setting: A Case Report.","authors":"Sagarika Bhole, T R V Wilkinson, Sushant Nair, Ashish Tiwari","doi":"10.1155/cro/3789997","DOIUrl":"10.1155/cro/3789997","url":null,"abstract":"<p><p>Fibrous dysplasia (FD) is a benign bone disorder characterized by replacement of normal bone with fibrous tissue and immature woven bone. Although rib involvement is not uncommon, large symptomatic lesions are rare. We report a case of giant monostotic FD of the sixth rib managed successfully in a resource-limited rural setting. A 22-year-old man presented with a progressively enlarging, painful swelling over the left chest wall for 3 years. Examination revealed a hard, immobile mass measuring 10 × 6 cm. Imaging showed a well-defined expansile lytic lesion with ground-glass matrix arising from the left sixth rib without cortical breach. Core biopsy confirmed FD. Owing to the lesion size, symptoms, and limited access to thoracoscopic facilities, open posterolateral thoracotomy with en bloc rib resection was performed. The resulting 8 × 6 cm defect was reconstructed using rib approximation without prosthetic mesh and covered with a pedicled latissimus dorsi flap. The postoperative course was uneventful, with complete recovery and no recurrence at 1-year follow-up. This case highlights that complete surgical excision provides excellent clinical outcomes for symptomatic rib FD and demonstrates that effective, low-cost reconstruction without synthetic materials is feasible in selected patients in resource-constrained settings.</p>","PeriodicalId":30287,"journal":{"name":"Case Reports in Orthopedics","volume":"2026 ","pages":"3789997"},"PeriodicalIF":0.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13533074/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148875814","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":"Acute Exertional Lateral Compartment Syndrome: A Diagnostic Challenge Presenting With Peroneal Nerve Palsy and Myoglobin-Mediated Acute Kidney Injury-A Case Report.","authors":"Marlon M Mencia, Cameron J Mencia, Pedro Pablo Hernandez-Cruz","doi":"10.1155/cro/5885194","DOIUrl":"10.1155/cro/5885194","url":null,"abstract":"<p><strong>Background: </strong>Acute exertional compartment syndrome (AECS) is a rare but limb-threatening condition that typically occurs in athletes or military recruits in the absence of trauma. Although the anterior compartment of the leg is most commonly affected, isolated lateral compartment involvement is distinctly uncommon. Delayed recognition is frequent and may result in serious complications, including acute kidney injury (AKI) and amputation.</p><p><strong>Case presentation: </strong>We report the case of a 37-year-old previously healthy man who presented with severe lateral leg pain, progressive swelling and acute foot drop approximately 12 h after a high-intensity interval training (HIIT) session. Initial investigations revealed markedly elevated creatine phosphokinase, myoglobin and creatinine levels, and he was admitted with a provisional diagnosis of rhabdomyolysis-induced AKI. Despite aggressive intravenous hydration, his biochemical parameters worsened and leg pain intensified. Clinical assessment demonstrated a tense lateral compartment and a diagnosis of acute exertional lateral compartment syndrome was made, and urgent fasciotomy was performed. Postoperatively, pain rapidly improved and renal function normalised over several days. At 2-year follow-up, the patient had residual weakness of ankle dorsiflexion (MRC Grade 4) but had returned to moderate physical activity.</p><p><strong>Conclusion: </strong>Acute exertional lateral compartment syndrome is an exceptionally rare diagnosis and may present atypically, leading to delayed treatment. Clinicians should maintain a high index of suspicion in patients presenting with severe leg pain and neurological deficit following exercise. Early diagnosis and prompt fasciotomy remain critical to optimising functional outcomes.</p>","PeriodicalId":30287,"journal":{"name":"Case Reports in Orthopedics","volume":"2026 ","pages":"5885194"},"PeriodicalIF":0.4,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13527517/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148866977","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 Morphological Variant of Postaxial Foot Polydactyly With an Accessory Articulating Osseous Structure of the Fifth Ray.","authors":"Ali M Aldossari, Ahmed K Alanazi, Norah I Alromaih, Sara N Albqami","doi":"10.1155/cro/5110521","DOIUrl":"10.1155/cro/5110521","url":null,"abstract":"<p><p>Postaxial polydactyly of the foot is a common form of digital duplication that often causes difficulty with footwear, metatarsalgia, and cosmetic concerns. Although it may present as an isolated anomaly, it can also be associated with genetic conditions. Surgical excision is the primary intervention, with generally excellent outcomes. A 5-year-old male presented with postaxial polydactyly of the left foot, characterized by an accessory articulating osseous structure associated with the fifth ray. The main complaints were difficulty with footwear and cosmetic appearance. Radiographic evaluation revealed a shortened, dysplastic fifth metatarsal associated with an accessory osseous structure that articulates with the duplicated lateral digits. The anatomical configuration did not completely correspond to existing classification systems. Surgical excision of the supernumerary digit and realignment of the metatarsal head were performed. At the 24-month follow-up, the patient demonstrated satisfactory radiographic healing, maintained toe alignment, painless full weight-bearing capacity, and an acceptable cosmetic appearance without postoperative complications. This case emphasizes the importance of detailed radiographic assessment and individualized surgical planning for rare anatomical variants of postaxial foot polydactyly that are not fully represented by current classification systems. Continued long-term follow-up is necessary to evaluate outcomes through skeletal growth.</p>","PeriodicalId":30287,"journal":{"name":"Case Reports in Orthopedics","volume":"2026 ","pages":"5110521"},"PeriodicalIF":0.4,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13519887/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148841323","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":"Transphyseal Separation of the Distal Humerus in a 5-Year-Old Child: A Rare Case Report.","authors":"Sushil Pokhrel, Shivaji Karki, Sushil Sah, Ganga Tiwari","doi":"10.1155/cro/9974926","DOIUrl":"10.1155/cro/9974926","url":null,"abstract":"<p><strong>Background: </strong>Transphyseal separation of the distal humerus (TSDH) is an uncommon injury, typically seen in children under 3 years of age, with very few cases reported beyond this age group. Diagnosing this injury is challenging due to its cartilaginous nature. TSDH in infants is commonly treated with manual reduction and long-arm cast application; however, a few case series have suggested that surgical treatment may be a better option in older children.</p><p><strong>Case summary: </strong>A 5-year-old boy presented with left elbow swelling and restricted movements after a fall on an outstretched hand 2 days earlier. On physical examination, the three-point bony relationship was maintained, and the distal neurovascular status was intact. Radiographs of the left elbow joint showed posteromedial displacement of the radioulnar complex with maintained radio-capitellar line. The TSDH was suspected, and intraoperative arthrography was planned. The diagnosis of TSDH was confirmed intraoperatively with the aid of arthrography. The patient underwent closed reduction and percutaneous K-wire fixation after confirming optimal alignment. Postoperatively, the elbow was immobilized using an above-elbow posterior slab. At 5 weeks, the slab was removed, and gradual range-of-motion exercises were initiated. At the 2-month follow-up, the child had a satisfactory range of motion. At the 15-month follow-up, the patient demonstrated an excellent, pain-free range of motion with no residual deformity or radiographic abnormalities.</p><p><strong>Conclusion: </strong>The TSDH in older children is a rare entity. The accurate reduction and timely diagnosis should be given priority so as to avoid late complications. If appropriate intervention is done ensuring adequate reduction and stable fixation, even with limited resources, excellent results can be achieved in such challenging cases.</p>","PeriodicalId":30287,"journal":{"name":"Case Reports in Orthopedics","volume":"2026 ","pages":"9974926"},"PeriodicalIF":0.4,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13520111/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148841360","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 Tibial Tubercle Avulsion Fractures Complicated by Compartment Syndrome in an Adolescent With Osteogenesis Imperfecta: A Case Report.","authors":"Tuckerman Jones, David Ahn, Rohan Suresh, Hyewon Kim, Sagie Haziza, Robert DalCortivo, Alexis Driscoll, Michael Metrione, Neil Kaushal","doi":"10.1155/cro/1337169","DOIUrl":"10.1155/cro/1337169","url":null,"abstract":"<p><strong>Background: </strong>Osteogenesis imperfecta (OI) is a rare collagen disorder causing brittle bones. Tibial tubercle fractures are uncommon in children, comprising < 2.7% of pediatric fractures, and bilateral injuries in OI are exceptionally rare. No prior reports detail bilateral tibial tubercle fractures with concurrent bilateral compartment syndrome. We present the first known case of this presentation in an 11-year-old boy.</p><p><strong>Case presentation: </strong>An 11-year-old male with OI fell on his knees, presenting with severe bilateral leg pain. Imaging revealed bilateral Ogden III tibial tubercle fractures. Due to tense compartments, emergent fasciotomies were performed, followed by open reduction and internal fixation. At 16-month follow-up, the patient reported no complications and demonstrated normal ambulation.</p><p><strong>Conclusion: </strong>Surgeons should maintain a high index of suspicion for compartment syndrome in patients with OI presenting with tibial tubercle fractures, including after low-energy mechanisms, and intervene promptly when clinically indicated.</p>","PeriodicalId":30287,"journal":{"name":"Case Reports in Orthopedics","volume":"2026 ","pages":"1337169"},"PeriodicalIF":0.4,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13504616/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148819584","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":"Iatrogenic Metacarpal Shaft Fracture Following Distal Radius External Fixator Removal in Clinic.","authors":"Kyle Scarano, Victoria Smith, Jeffrey Bair","doi":"10.1155/cro/2443237","DOIUrl":"10.1155/cro/2443237","url":null,"abstract":"<p><strong>Background: </strong>External fixation remains an accepted option for certain unstable distal radius fractures, particularly when ligamentotaxis and percutaneous augmentation can restore and maintain alignment. Known complications include pin-tract infection, loss of reduction, nerve irritation, stiffness, and complex regional pain syndrome. Fracture through a metacarpal Schanz pin site during in-clinic removal has not, to our knowledge, been specifically described.</p><p><strong>Case presentation: </strong>A 70-year-old right-hand-dominant female sustained a shortened, dorsally angulated, extra-articular fracture of the left distal radius after a fall from standing height. After persistent displacement following attempted closed reduction, operative options were discussed, including volar locked plating versus closed reduction with percutaneous pinning and wrist-spanning external fixation. The patient underwent closed reduction, percutaneous Kirschner-wire augmentation, and wrist-spanning external fixation using radial and second-metacarpal Schanz pins. At approximately 8 weeks, radiographs demonstrated distal radius healing and the patient elected in-clinic external fixator removal rather than removal in the operating room. During removal, the distal second-metacarpal 3.0-mm threaded/4.0-mm shaft Schanz pin was cut below the clamp with large pin cutters. The patient experienced immediate pain at the pin site, and postremoval radiographs demonstrated a nondisplaced second metacarpal shaft fracture through the distal pin tract. The fracture was treated nonoperatively and progressed to radiographic union.</p><p><strong>Conclusion: </strong>This case highlights a potentially preventable complication of external fixator removal from small-diameter long bones. When removing wrist-spanning external fixators, particularly in older patients or those with decreased bone quality, clinicians should consider disassembling the construct and removing metacarpal pins intact rather than cutting pins under constraint. When pin cutting is unavoidable, support of the pin-bone interface and avoidance of torsional or recoil forces may reduce fracture risk.</p>","PeriodicalId":30287,"journal":{"name":"Case Reports in Orthopedics","volume":"2026 ","pages":"2443237"},"PeriodicalIF":0.4,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13504244/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148819530","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":"Salvaging Early EndoButton Migration in PCL Reconstruction: A Case Report Describing a Novel Technical Solution for Femoral Tunnel Complications.","authors":"Daichi Ishimaru, Kazuki Sohmiya, Nobuo Terabayashi, Kazu Matsumoto","doi":"10.1155/cro/3787522","DOIUrl":"10.1155/cro/3787522","url":null,"abstract":"<p><strong>Introduction: </strong>Recently, the number of posterior cruciate ligament (PCL) reconstruction surgeries has been increasing. A rare complication of early intratunnel migration of a suspensory cortical button into the femoral tunnel after PCL reconstruction was observed.</p><p><strong>Case presentation: </strong>A 51-year-old man presented with an isolated PCL rupture and underwent PCL reconstruction surgery. A quadrupled semitendinosus autograft was used; femoral fixation was achieved with a fixed-loop suspensory cortical button (EndoButton; Smith & Nephew), and tibial fixation was achieved with a cortical post technique using a double spike plate (DSP; Smith & Nephew), rather than an interference screw. Seven days after the operation, a radiograph of the knee demonstrated that the EndoButton had migrated into the femoral tunnel. The patient underwent prompt reoperation, and the EndoButton was manually repositioned and augmented by placing a large button onto it to prevent remigration.</p><p><strong>Conclusions: </strong>This case suggests that early postoperative intratunnel migration of a suspensory cortical button after PCL reconstruction can be successfully managed with prompt surgical reduction and augmentation.</p>","PeriodicalId":30287,"journal":{"name":"Case Reports in Orthopedics","volume":"2026 ","pages":"3787522"},"PeriodicalIF":0.4,"publicationDate":"2026-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13501012/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148814262","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":"Complete Anterior Tibial Tendon Rupture After Closed Tibial Shaft Fracture: A Case Report.","authors":"Juanita Villalba Reyes, Juanita Fetecua Chaparro, Julián Salavarrieta Varela, Diana Paola Montoya Murillo, Nicolás Jiménez Arrieta","doi":"10.1155/cro/3083462","DOIUrl":"10.1155/cro/3083462","url":null,"abstract":"<p><p>Acute anterior tibialis tendon (ATT) rupture is a rare injury that may go unrecognized in the acute trauma setting, particularly when it co-occurs with a closed tibial shaft fracture. We report a case of complete ATT rupture in a 25-year-old male following a motorcycle accident causing a distal tibial shaft fracture. The rupture was identified intraoperatively; during distal locking screw placement, tendon-like fibers were observed through the surgical incision. Given this unexpected finding, the incision was extended to allow further exploration. Careful dissection revealed a complete rupture of the anterior tibial tendon, which had not been identified preoperatively. Because of significant soft-tissue edema at the time of fracture fixation, a staged surgical approach was adopted: temporary proximal stump fixation to the superior extensor retinaculum followed by definitive end-to-end repair 10 days later using Krakow and modified Kessler sutures. At 6 months, MRI confirmed tendon continuity, dorsiflexion strength was 4/5, and the AOFAS score was 90 (excellent). This case illustrates the diagnostic challenge of ATT rupture concurrent with tibial fracture and highlights that opportunistic visualization of the tendon may occur during distal locking procedures when the fracture apex is anteriorly oriented-an anatomical coincidence that, when recognized, enables timely repair. The principal clinical lessons are as follows: (1) the importance of including ATT integrity in the assessment of tibial fractures with anterior apex angulation or dorsiflexion deficit; (2) a staged approach is feasible and effective when soft-tissue conditions preclude immediate repair; and (3) early surgical repair, when stumps are viable, is associated with excellent functional outcomes.</p>","PeriodicalId":30287,"journal":{"name":"Case Reports in Orthopedics","volume":"2026 ","pages":"3083462"},"PeriodicalIF":0.4,"publicationDate":"2026-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13500996/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148814190","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}