Case Reports in Orthopedics最新文献

{"title":"Metachronous Multifocal Extradigital Glomus Tumor of Lower Extremity: A Case Report and Literature Review.","authors":"Giulia De Marco, Giuseppe Francesco Papalia, Luisana Sisca, Francesco Luigi Gambaro, Bruno Vincenzi, Nicola Papapietro","doi":"10.1155/cro/1411715","DOIUrl":"10.1155/cro/1411715","url":null,"abstract":"<p><p>The glomus tumor (GT) is a rare benign neoplasm, generally located in the subungual region of the distal phalanx of the fingers as a single nodule. While approximately 90% of digital GTs are correctly diagnosed (pain, cold sensitivity, and point tenderness), extradigital forms often present with silent or atypical features, complicating diagnosis. The treatment of choice is surgical excision, associated with low recurrence rates. In October 2022, a 64-year-old man presented with a painful, palpable mass in the distal third of the right femur. Magnetic resonance and computed tomography revealed a solid lesion involving the distal third of the femur. A needle biopsy confirmed the diagnosis of GT with hemangiopericytoma-like features. In January 2023, surgical excision was performed, and histology confirmed the diagnosis. The patient had a significant oncologic history: In 1994, he underwent wide resection and adjuvant chemotherapy for a high-grade undifferentiated sarcoma of the right thigh. In November 2012, he reported a painful mass in the right ankle, and excisional biopsy with immunohistochemistry led to a diagnosis of multifocal GT. At his last follow-up in November 2025, he was in good general health under oncologic surveillance. We conducted a search on PubMed and Scopus using the keywords \"extra digital glomus tumor\" and included articles reporting extra digital GTs of the lower limb. The literature review identified 143 patients with extradigital GT with lower limb involvement. This case represents a rare presentation because of its unusual lower limb location, with lesions in the ankle in 2012 and the femur in 2022. We report a rare case of a late metachronous extradigital GT of the lower limb in an unusual anatomical site.</p>","PeriodicalId":30287,"journal":{"name":"Case Reports in Orthopedics","volume":"2026 ","pages":"1411715"},"PeriodicalIF":0.4,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13397867/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148585344","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":"<i>Dirofilaria immitis</i> Causing Flexor Tenosynovitis of the Hand: A Rare Case Report.","authors":"Jamie C Henzes, John T Rich","doi":"10.1155/cro/3569396","DOIUrl":"10.1155/cro/3569396","url":null,"abstract":"<p><p>This case describes a previously underreported case of flexor tenosynovitis. A 23-year-old male slaughterhouse employee presented with several weeks of increased pain and swelling in their left third digit. They failed nonoperative management, including anti-inflammatory medication and oral steroids, followed by corticosteroid injection. Intraoperative pathology demonstrated subacute flexor tenosynovitis due to a rare parasitic infection of <i>Dirofilaria immitis</i>. <i>Dirofilaria immitis</i>, a parasitic roundworm commonly found in dogs, rarely causes zoonotic infections in humans. In cases when this parasite infects humans, it primarily impacts pulmonary, ocular, and subcutaneous tissues. This diagnosis was ultimately only able to be made due to pathologic analysis, as they had negative cultures. This case highlights that tissue pathology is essential in atypical infections, especially culture-negative tenosynovitis.</p>","PeriodicalId":30287,"journal":{"name":"Case Reports in Orthopedics","volume":"2026 ","pages":"3569396"},"PeriodicalIF":0.4,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13392409/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148580379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical Decision-Making in the Setting of Diagnostic Uncertainty in Upper Extremity Subcutaneous Emphysema.","authors":"Annie R Waite, Sanjit Menon, Clayton W Maschhoff, Paul P Hospodar, Kaushik Bagchi","doi":"10.1155/cro/5229108","DOIUrl":"10.1155/cro/5229108","url":null,"abstract":"<p><strong>Background: </strong>Necrotizing soft tissue infections (NSTIs) are life-threatening and require emergent surgical debridement. Benign subcutaneous emphysema is a rare, noninfectious condition characterized by subcutaneous gas on imaging without systemic symptoms or abnormal laboratory values typical of NSTIs. Patients with subcutaneous emphysema and risk factors for NSTI can pose a diagnostic challenge.</p><p><strong>Case report: </strong>We report an 18-year-old female with Ehlers-Danlos syndrome who developed left elbow pain and crepitus following multiple insect bites, freshwater pond exposure, and contact with farm animals. She was afebrile with a benign exam and normal labs, yet imaging demonstrated extensive upper extremity subcutaneous emphysema. Given the concern for NSTI, she was admitted on broad-spectrum antibiotics and underwent surgical exploration. Normal intraoperative findings, along with negative cultures and pathology, confirmed the diagnosis of benign subcutaneous emphysema. She was discharged postoperatively with oral antibiotics and made a full recovery.</p><p><strong>Conclusion: </strong>This case highlights the importance of multidisciplinary evaluation in differentiating benign from life-threatening subcutaneous emphysema to guide appropriate management and avoid unnecessary surgery.</p>","PeriodicalId":30287,"journal":{"name":"Case Reports in Orthopedics","volume":"2026 ","pages":"5229108"},"PeriodicalIF":0.4,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13392414/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148580413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical Approaches to Brachial Plexus Schwannomas: A Multidisciplinary Case Report.","authors":"Logan A Reed, Justin Cline, Justin Zumsteg, Karan Desai","doi":"10.1155/cro/6094879","DOIUrl":"10.1155/cro/6094879","url":null,"abstract":"<p><strong>Background: </strong>Brachial plexus schwannomas are rare tumors requiring individualized surgical planning. Despite established surgical principles, the optimal approach varies substantially by tumor location, and direct comparative data across techniques remain limited.</p><p><strong>Cases: </strong>We present three cases illustrating distinct surgical strategies. A 59-year-old woman with foraminal and intradural extension underwent staged posterior laminectomy followed by supraclavicular resection, who recovered with no clinically significant neurologic deficits. A 69-year-old woman with upper trunk involvement had successful supraclavicular excision with complete symptom resolution. A 68-year-old man with a retroclavicular tumor required transclavicular access via clavicular osteotomy; he experienced immediate pain relief but developed osteotomy nonunion requiring revision fixation before achieving full functional recovery at 2.5 years.</p><p><strong>Conclusion: </strong>These cases demonstrate that approach selection should be driven by tumor location, anatomical extent, and intradural involvement. Careful anatomical assessment and multidisciplinary collaboration are important considerations for maximizing resection while preserving neurological function.</p>","PeriodicalId":30287,"journal":{"name":"Case Reports in Orthopedics","volume":"2026 ","pages":"6094879"},"PeriodicalIF":0.4,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13389236/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148562833","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":"All-Suture Anchor Fixation for Coronoid Process Fractures via a Transolecranon Fracture Approach.","authors":"Yuxuan Wu, Yang Lu, Jianlan Wang, Jiang Mu, Shuang Zhang","doi":"10.1155/cro/6402842","DOIUrl":"10.1155/cro/6402842","url":null,"abstract":"<p><strong>Background: </strong>Coronoid process fractures are a common component of elbow injuries and present significant challenges in surgical management. The all-suture anchor fixation technique, as an emerging method, offers a novel alternative for stabilizing these fractures. By enabling dual-directional fixation, this approach provides bidirectional mechanical support, resulting in enhanced stabilization of the fracture fragment.</p><p><strong>Case presentation: </strong>A 35-year-old male presented with a complex proximal ulnar fracture involving both the coronoid process (O'Driscoll Type III) and the olecranon. Surgical fixation was performed using an all-suture anchor inserted at the fracture site, with sutures strategically tied to a fixation plate, establishing a stable tension-band configuration. This construct provided controlled traction and stable three-dimensional support of the fragment. Postoperative recovery was uneventful, with full restoration of elbow function and no evidence of fragment displacement or complications.</p><p><strong>Conclusion: </strong>This case illustrates the technical feasibility of the all-suture anchor technique for coronoid fractures. In cases of complex proximal ulnar fractures, this technique allows for simultaneous fixation of the coronoid and olecranon through a single posterior approach, reducing soft tissue disruption.</p>","PeriodicalId":30287,"journal":{"name":"Case Reports in Orthopedics","volume":"2026 ","pages":"6402842"},"PeriodicalIF":0.4,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13386111/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148550573","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":"Ultrafast Return to Sport in International Feminine Football Following Arthroscopic Anatomic Lateral Ankle Ligament Reconstruction Using Gracilis Autograft: A Case Report.","authors":"Pierre-Jean Lambrey, Germain Saniel, Ronny Lopes","doi":"10.1155/cro/5568199","DOIUrl":"10.1155/cro/5568199","url":null,"abstract":"<p><p>Lateral ankle instability is a common condition in elite football, but returning to play following arthroscopic anatomic ligament reconstruction (AALR) typically requires 4-6 months. We report the case of a 24-year-old professional female football player who achieved a full return to elite competition and national team duties within 12 weeks following arthroscopic ALR of the anterior talofibular (ATFL) and calcaneofibular (CFL) ligaments using an autologous gracilis graft. Preoperative instability followed recurrent sprains incurred during the World Cup, with examination and imaging demonstrating complete lateral ligament complex insufficiency. Arthroscopic exploration identified a complete ATFL/CFL rupture, anterolateral impingement, and a lateral talar chondral rail lesion, which were treated by synovectomy, debridement, and AALR. Rehabilitation followed an intensive, criterion-based protocol integrating immediate full weight-bearing, progressive range of motion, neuromuscular training, strength symmetry targets, and field-based functional testing. At 12 weeks, the athlete achieved full functional symmetry: AnkleGO score 25/25, FAAM-ADL and FAAM-Sport 100%, ALR-RSI 100%, symmetric hop performance, and unrestricted football-specific metrics. She returned to international duty without restrictions and completed full match participation. This case illustrates that arthroscopic anatomic reconstruction combined with structured high-performance rehabilitation can enable ultrafast return to elite football, challenging conventional timelines while illustrating an accelerated, criterion-based return in a single elite athlete rather than a generalizable target.</p>","PeriodicalId":30287,"journal":{"name":"Case Reports in Orthopedics","volume":"2026 ","pages":"5568199"},"PeriodicalIF":0.4,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13386113/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148550563","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":"Effect of Osteoperiosteal Decortication With Bone Grafting on Healing of Femoral Fracture Nonunion.","authors":"Mohammed M Elgack, Ahmed Mohamed Sonbol, Farid N Kassab, Mohamed Awad A Mohamed, Rima Yassin, Elsayed Shaheen, Hassan Sirajaldeen Alhassan Ali","doi":"10.1155/cro/9993269","DOIUrl":"10.1155/cro/9993269","url":null,"abstract":"<p><p>Femoral fractures are common injuries, typically demonstrating favorable outcomes with appropriate treatment. However, nonunion may occur due to several reasons. Osteoperiosteal decortication with bone grafting, initially described by Judet in 1969, has been recognized as a safe and effective method for managing nonunions. In this study, we aimed to determine the efficacy of this technique based on our experience in treating femoral nonunion. This case series included patients with femoral fracture nonunion who were treated with osteoperiosteal decortication performed by a single surgeon between April 2011 and January 2020. Data was collected from patients' medical records and hospital documents. The primary outcome measure was the attainment of clinical and radiographic unions during the follow-up period. The study included eight patients, including seven patients with diaphyseal fractures. Union was successfully achieved in all the patients. The mean time to union was approximately 6.13 ± 2 months. Five patients resumed full weight-bearing activities before 6 months. No additional procedures were required for any patient. In conclusion, osteoperiosteal decortication with bone grafting is an effective treatment approach for managing nonunions with promising success rates. The outcomes were satisfactory, as evaluated through clinical and radiological examinations.</p>","PeriodicalId":30287,"journal":{"name":"Case Reports in Orthopedics","volume":"2026 ","pages":"9993269"},"PeriodicalIF":0.4,"publicationDate":"2026-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13382154/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148606967","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":"Multilobed Osteochondroma of the Posterior Humeral Midshaft: A Rare Morphological Variant.","authors":"Feras Abuqweider, Abdul Haq Mahmoud Shahin, Anas R A Bayyoud Qasrawi, Ranya Abu Khalaf, Abdallah Badarna, Hanin Shatrit, Momen Sulyman, Mostafa Ibraheem, Qais Alnjoom","doi":"10.1155/cro/7763381","DOIUrl":"10.1155/cro/7763381","url":null,"abstract":"<p><p>Osteochondroma, or osseocartilaginous exostosis, is the most common benign bone tumor, accounting for approximately 30%-35% of benign bone lesions and predominantly arising from the metaphyseal regions of long bones in young males. Mid-diaphyseal origin and multilobed morphology are exceptionally uncommon and may present diagnostic and surgical challenges. We report a rare case of a solitary, multilobed osteochondroma arising from the posterior humeral midshaft in an 18-year-old male. The patient presented with a 1-year history of a gradually enlarging, painless mass over the lateral aspect of the left upper arm, without functional limitation or neurovascular symptoms. Physical examination revealed a firm, immobile, nontender mass with intact distal neurovascular status. Magnetic resonance imaging demonstrated a pedunculated osseous lesion measuring 6.5 × 3.3 × 2.3 cm, exhibiting continuity with the humeral medullary cavity and a distinctive three-lobed configuration, including a bilobed stalk. The cartilage cap thickness measured approximately 4 mm, with no surrounding soft tissue abnormalities. Surgical excision was performed via a posterior longitudinal approach, with careful identification and preservation of the radial nerve. Intraoperatively, three distinct pedunculated bony stalks arising from the posterior humeral midshaft were excised en bloc. Histopathological analysis confirmed a benign osteochondroma, showing mature trabecular bone capped by hyaline cartilage without atypia or malignant features. To the best of our knowledge, no previous report has specifically described this combination of posterior humeral mid-diaphyseal location and multilobed morphology. This case expands the anatomical and morphological spectrum of osteochondroma and highlights the critical role of advanced imaging in preoperative planning, particularly for lesions in proximity to major neurovascular structures. Recognition of such atypical presentations is essential to ensure accurate diagnosis, safe surgical management, and avoidance of iatrogenic complications.</p>","PeriodicalId":30287,"journal":{"name":"Case Reports in Orthopedics","volume":"2026 ","pages":"7763381"},"PeriodicalIF":0.4,"publicationDate":"2026-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13379894/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148498015","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 Case of Nonanatomic Alignment: Acute Radial Head Dislocation Following Radial Shaft Osteosynthesis.","authors":"Khalid H Almaazmi, Saif S Aldhuhoori","doi":"10.1155/cro/3498572","DOIUrl":"10.1155/cro/3498572","url":null,"abstract":"<p><p>Radial head dislocation after both bone forearm fractures (BBFF) fixation is rare. The management of BBFF involves open reduction and internal fixation (ORIF) to restore anatomy and function. Anatomic reduction of the radius and ulna is required to restore the unique geometric relationship of the forearm and allow normal rotation. Nonanatomic reduction of the radius can result in postoperative radial head dislocation, disrupting forearm function and stability.</p>","PeriodicalId":30287,"journal":{"name":"Case Reports in Orthopedics","volume":"2026 ","pages":"3498572"},"PeriodicalIF":0.4,"publicationDate":"2026-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13379891/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148498038","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":"Disseminated Culture-Negative Periprosthetic Knee Infection With Multifocal Septic Arthritis Associated With <i>Mycoplasma pneumoniae:</i> A Case Report.","authors":"Brett Barthman, Matthew Klassen, Adrian Ressing, Kristopher Danielson","doi":"10.1155/cro/9426714","DOIUrl":"10.1155/cro/9426714","url":null,"abstract":"<p><p>We report a case of a 72-year-old woman with Waldenström macroglobulinemia who developed a culture-negative periprosthetic joint infection (PJI) of the right knee following total knee arthroplasty. Despite multiple debridements and broad-spectrum antibiotics, she developed systemic signs of infection and hematogenous spread to multiple native joints, including the contralateral knee, ankle, wrist, and lumbar facet joints. All intraoperative cultures remained negative. A respiratory PCR was performed, which detected <i>Mycoplasma pneumoniae</i>, and metagenomic next-generation sequencing (mNGS) of plasma supported the diagnosis of the pathogen. Based on these findings, therapy was narrowed to doxycycline, resulting in clinical improvement and deferral of further surgery. This case highlights the importance of considering atypical pathogens in culture-negative PJI and demonstrates the utility of mNGS in guiding targeted antimicrobial therapy.</p>","PeriodicalId":30287,"journal":{"name":"Case Reports in Orthopedics","volume":"2026 ","pages":"9426714"},"PeriodicalIF":0.4,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13370799/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148457021","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}