Case Reports in Orthopedics最新文献

{"title":"Salvage After Patient-Driven Delayed Conversion From External Fixation to Intramedullary Nailing in an Open Tibial Shaft Fracture: A Case Report.","authors":"Md Sulaiman","doi":"10.1155/cro/1572775","DOIUrl":"10.1155/cro/1572775","url":null,"abstract":"<p><strong>Background: </strong>Open tibial shaft fractures require timely management of both skeletal instability and soft-tissue injury. Temporary external fixation is useful for early stabilization, but prolonged retention without progression to definitive fixation may increase the risk of delayed union and other complications. This case illustrates a patient-driven delay from the preferred staged pathway and subsequent salvage after restoration of mechanical stability and biological support.</p><p><strong>Case presentation: </strong>A 40-year-old man sustained a Gustilo-Anderson Type II open fracture of the right tibial shaft with an associated fibular fracture following a road traffic accident. He presented approximately 40 min after injury with a clean 2 cm wound over the anteromedial midleg and intact distal neurovascular status. Immediate preoperative radiographs before initial stabilization were unavailable because the case was reviewed retrospectively. After resuscitation and optimization, irrigation, debridement, primary wound closure, drain placement, and monolateral external fixation were performed on November 22, 2024. Serial follow-up radiographs showed maintained alignment but limited progression toward union. Early conversion to intramedullary nailing was advised, but the patient initially declined further surgery for personal and socioeconomic reasons. On February 12, 2025, the external fixator was removed and intramedullary interlocking nailing with autogenous bone grafting was performed as a salvage procedure. Follow-up radiographs showed progressive callus formation and solid union at late follow-up on March 27, 2026. No postoperative wound complication or deep infection occurred.</p><p><strong>Conclusions: </strong>This case should not be interpreted as supporting delayed conversion as routine practice. Rather, it illustrates a cautionary salvage scenario in which patient-driven delay disrupted the preferred staged pathway, and union was achieved only after definitive restoration of stability and selective biological support.</p>","PeriodicalId":30287,"journal":{"name":"Case Reports in Orthopedics","volume":"2026 ","pages":"1572775"},"PeriodicalIF":0.4,"publicationDate":"2026-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13250250/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148228549","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 Report of an Intradural Extramedullary Tumor, Which Was Treated With Steroid and Clinically Suspected as Neural Sarcoidosis.","authors":"Shogo Suenaga, Kenji Kato, Kiyoshi Yagi, Hideki Murakami, Nobuyuki Suzuki","doi":"10.1155/cro/9401516","DOIUrl":"10.1155/cro/9401516","url":null,"abstract":"<p><p>Sarcoidosis is a systemic disease that is represented by lymph node swelling of the lung with pathologically diagnosed nonfibromatous necrosis. We report a rare case that was clinically diagnosed as an intradural extramedullary tumor of sarcoidosis, which was treated with oral steroid medication. A 45-year-old woman visited a local clinic due to leg pain and muscle weakness. MRI showed an intradural extramedullary tumor at the level from Th 4 to 5. The radiologist's comment on MRI suggested that the tumor was a meningioma. She was referred to our hospital for emergency surgery due to muscle weakness. On administration, the muscle strength was Grade 4 on manual muscle testing and no bladder or rectal disorder was observed. The appearance of the tumor was not typical for the diagnosis of meningioma and the prior diagnosis could be neural sarcoidosis or a hematologic tumor as differential diagnoses. Lab data and bone marrow aspiration did not prove a hematologic tumor. CT revealed bilateral hilar lymphadenopathies, whereas pathological examination by bronchoscopy did not show evidence of sarcoidosis, such as caseating granuloma. Since resection of intradural tumors carries a high risk of complications, the mass was clinically suspected as sarcoidosis and treatment of the tumor with steroid started. After treatment, the pain and muscle weakness diminished soon, and 2 months later, the tumor clearly disappeared. In the follow-up period, she also suffered heart sarcoidosis and continued steroid therapy for heart problems. If intradural extramedullary sarcoidosis was diagnosed before surgery, patients do not need surgery. It is important for surgeons to know this disease.</p>","PeriodicalId":30287,"journal":{"name":"Case Reports in Orthopedics","volume":"2026 ","pages":"9401516"},"PeriodicalIF":0.4,"publicationDate":"2026-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13243199/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148212913","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 Encounter: Documenting a Rotator Cuff Tear Associated With Idiopathic Rice Bodies.","authors":"Ekrem Özdemir, Oya Olcay Özdeş, Hüseyin Utku Özdeş","doi":"10.1155/cro/2370288","DOIUrl":"10.1155/cro/2370288","url":null,"abstract":"<p><p>We share a case of a cuff tear caused by rice bodies, which typically occur in chronic inflammatory conditions and are often seen in autoimmune diseases. A 62-year-old patient presented with pain and restricted movement in the left shoulder. Magnetic resonance imaging revealed numerous rice body-like accumulations in the subacromial region, and a cuff tear was observed. The patient had no additional comorbidities in the medical history and no signs of infection on physical examination. Surgery was performed to repair the cuff rupture and excise the deposits. The histopathological examination of the excised material confirmed the presence of rice bodies. During the 20-month follow-up, the patient's shoulder function improved and pain decreased. Although cuff tendinopathy is very common, cuff tears secondary to rice body synovitis and its mechanical effects are extremely rare. It should be noted that rice bodies developing in the context of chronic inflammation can present as a shoulder mass without systemic findings in the early stages. Although they may appear idiopathic, patients should be evaluated and counseled regarding possible autoimmune predisposition. In our case, infectious and autoimmune etiologies were carefully excluded through clinical, laboratory, and histopathological assessments.</p>","PeriodicalId":30287,"journal":{"name":"Case Reports in Orthopedics","volume":"2026 ","pages":"2370288"},"PeriodicalIF":0.4,"publicationDate":"2026-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13238240/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148200279","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":"Bilateral Patellar Tendon Rupture in a 64-Year-Old Man: Possible Interaction of Inhaled Corticosteroids, Age and Mechanical Stress.","authors":"Mohamed Jalaleddin, Pavun Basra, Christopher Jordan, Benjamin H L Harris, Louis J Koizia","doi":"10.1155/cro/9959487","DOIUrl":"10.1155/cro/9959487","url":null,"abstract":"<p><p>Bilateral rupture of the patellar tendon is a rare occurrence, most often associated with systemic disease or exposure to systemic corticosteroids or fluoroquinolones. We report the case of a 64-year-old man with bronchiectasis managed with long-term inhaled corticosteroids who sustained bilateral patellar tendon rupture following a low-energy deceleration while crossing the road. He underwent bilateral patellar tendon repair with medial and lateral retinacular reinforcement and was managed postoperatively with a structured rehabilitation programme. At 28-week follow-up, he remained independently ambulant with no evidence of tendon re-rupture. The patient had several recognised contributors to tendon vulnerability, including advanced age and prolonged inhaled corticosteroid exposure. Although inhaled corticosteroids confer lower systemic bioavailability than oral preparations, long-term use may contribute to tendon vulnerability, particularly when combined with additional mechanical or degenerative factors; however, causality cannot be confirmed. No histological analysis, preinjury imaging, or biochemical tendon assessment were available to characterise baseline tendon integrity. This case highlights the importance of enquiring about chronic inhaled corticosteroid use and considering the additive interaction of multiple risk factors when evaluating spontaneous tendon rupture.</p>","PeriodicalId":30287,"journal":{"name":"Case Reports in Orthopedics","volume":"2026 ","pages":"9959487"},"PeriodicalIF":0.4,"publicationDate":"2026-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13239303/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148200270","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":"When a Benign Tumor Turns Troublesome: A Case Report of Deep Lipoma Compressing the Posterior Interosseous Nerve.","authors":"Pushkar Pudasaini, Lok Raj Chaurasia, Kiran Kishor Nakarmi","doi":"10.1155/cro/5819552","DOIUrl":"10.1155/cro/5819552","url":null,"abstract":"<p><p>This case report presents a rare instance of posterior interosseous nerve (PIN) compression caused by a deep lipoma in a patient. The patient was undiagnosed even after visiting multiple doctors and obvious clinical signs were missed. The clinical presentation, diagnostic approach, surgical intervention, and outcome are discussed. This case highlights the importance of considering rare causes of nerve compression and underscores the critical role of clinical examination in guiding diagnosis and management, particularly in resource-constrained environments. Furthermore, this case also shows that good recovery can be achieved even when there is severe and prolonged compression.</p>","PeriodicalId":30287,"journal":{"name":"Case Reports in Orthopedics","volume":"2026 ","pages":"5819552"},"PeriodicalIF":0.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13239137/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148200190","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":"Flexor Tendon Sheath Ganglion Causing Concurrent Trigger Wrist and Carpal Tunnel Syndrome.","authors":"Mohamed Alsharif, Abdulaziz Mhannayeh, Abdullah Jabri, Bader Taftafa, Raghad Alsharif, Rama Summak, Moustafa Saeed, Abdulaziz Al-Sharif","doi":"10.1155/cro/8963799","DOIUrl":"10.1155/cro/8963799","url":null,"abstract":"<p><strong>Introduction: </strong>Trigger wrist is a rare condition often misdiagnosed as trigger finger or carpal tunnel syndrome (CTS). It is characterized by painful clicking, snapping, or locking of the wrist during movement and can result from space-occupying lesions, such as ganglion cysts. This case highlights an unusual presentation of trigger wrist associated with CTS caused by a ganglion cyst in the flexor tendon sheath.</p><p><strong>Case presentation: </strong>A 44-year-old male presented with paresthesia, severe pain, and triggering of the right wrist. Imaging and histopathology confirmed a ganglion cyst between the flexor digitorum profundus tendons of the index and middle fingers, compressing the median nerve and causing CTS. Surgical excision via a carpal tunnel approach resulted in complete symptom resolution.</p><p><strong>Conclusion: </strong>This case emphasizes the diagnostic challenges of trigger wrist and the importance of considering it in patients with CTS-like symptoms and mechanical wrist dysfunction. Ganglion cysts in flexor tendon sheaths are rare, and surgical excision remains an effective treatment. Increased awareness and reporting of such cases can improve clinical recognition and management.</p>","PeriodicalId":30287,"journal":{"name":"Case Reports in Orthopedics","volume":"2026 ","pages":"8963799"},"PeriodicalIF":0.4,"publicationDate":"2026-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13239440/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148200235","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":"Inferior Pubic Rami Stress Fracture in a High School Sprinter: A Case Report.","authors":"Tyler Janitz, Rutledge Feltel, Tyler Schmitz, Jeff Nadwodny, Daniel Montero, George Pujalte","doi":"10.1155/cro/9959554","DOIUrl":"10.1155/cro/9959554","url":null,"abstract":"<p><strong>Background: </strong>Pubic rami stress fractures comprise 1%-2% of all stress fractures and are most often seen in military recruits and long-distance athletes; they are less commonly reported in short distance athletes. We present an atypical inferior pubic rami stress fracture in a high school sprinter and discuss the current treatment standards along with broad clinical implications of the case.</p><p><strong>Case presentation: </strong>A 15-year-old female high school track athlete presented to the sports medicine clinic with right hip pain after she felt a pop around her posterior right hip while running a 100-m sprint approximately 4 weeks prior. The pain was associated with severe, nonradiating pain, and inability to run afterwards. She came with bilateral hip and pelvic X-rays from an outside facility that were reported as normal. However, the overread of the images by the sports medicine provider revealed a nondisplaced, subacute right inferior pubic rami stress fracture. The patient was instructed to refrain from running for 3 months. Repeat imaging at 2- and 3-months postinjury revealed progressive healing that clinically correlated with symptom improvement. She then entered a return-to-run program with physical therapy and had full return to sport without limitation at 5 months postinjury.</p><p><strong>Conclusion: </strong>It is important that sports medicine and orthopedic providers take a holistic approach, considering a broad differential that may be contributing to a patient's presentation, even if the answer is a known fracture entity in a less frequently reported athletic subgroup.</p>","PeriodicalId":30287,"journal":{"name":"Case Reports in Orthopedics","volume":"2026 ","pages":"9959554"},"PeriodicalIF":0.4,"publicationDate":"2026-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13240375/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148200202","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":"Bilateral Distal Patellar Tendon Rupture in a 10-Year-Old Child: A Case Report and Review of the Literature.","authors":"Elvin Gurbanov, Oscar Vazquez, Tiago Guedes Almeida, Dimitri Ceroni, Giacomo De Marco","doi":"10.1155/cro/3635857","DOIUrl":"10.1155/cro/3635857","url":null,"abstract":"<p><strong>Background: </strong>Patellar tendon rupture is a rare lesion that usually occurs in adult patients with predisposing factors. The condition is even rarer in pediatric populations and presents either as a sleeve fracture of the patella's inferior pole or as an avulsion of the tibial tubercle. The present report describes the case of a healthy 10-year-old female with bilateral, purely tendinous distal avulsions of her patellar tendons and considers her clinical presentation, treatment, and the clinical outcome.</p><p><strong>Methods: </strong>A 10-year-old female was admitted to Geneva University Hospitals and diagnosed with bilateral patellar tendon ruptures. The patient underwent bilateral tendon repair using four anchor sutures for each tendon and augmentation with a transpatellar metallic wire.</p><p><strong>Results: </strong>Postsurgical follow-up out to 1 year showed good results, with the restoration of a full range of motion, an absence of pain, and a complete return to sports activities.</p><p><strong>Conclusion: </strong>This case report describes the very rare bilateral rupture of an otherwise healthy 10-year-old female's patellar tendons in their soft tissue substance. It details the treatment, follow-up, and positive outcome.</p>","PeriodicalId":30287,"journal":{"name":"Case Reports in Orthopedics","volume":"2026 ","pages":"3635857"},"PeriodicalIF":0.4,"publicationDate":"2026-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13239474/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148200262","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":"Aneurysmal Bone Cyst of the Coracoid Process: A Case Report.","authors":"André Castanheira, Pedro Amaro, Raquel Costa, Hugo Santos, Nuno Oliveira, Luís Pires","doi":"10.1155/cro/1355059","DOIUrl":"10.1155/cro/1355059","url":null,"abstract":"<p><strong>Background: </strong>Aneurysmal bone cysts (ABCs) are benign yet locally aggressive lesions that can cause significant bone destruction. Involvement of the coracoid process is exceedingly rare, and the diagnosis is particularly challenging due to its atypical presentation.</p><p><strong>Case presentation: </strong>We report the case of a 37-year-old male with right shoulder pain initially attributed to calcific tendinitis. Advanced imaging incidentally revealed an asymptomatic ABC of the coracoid process. Surgical management involved intralesional curettage and cavity filling with a biphasic calcium sulfate-hydroxyapatite bone graft substitute. Histopathological analysis confirmed the diagnosis of a benign ABC. Postoperative recovery was uneventful, and at 1-year follow-up, the patient was asymptomatic with full shoulder function. Follow-up CT imaging showed no evidence of recurrence and resolution of the initial calcific tendinitis.</p><p><strong>Conclusion: </strong>This case highlights the importance of advanced imaging in atypical shoulder pain and demonstrates that biphasic bone graft substitutes offer a safe and effective alternative to traditional bone grafting in the treatment of ABCs, even in rare anatomical locations. Further research is needed to validate long-term outcomes and establish standardized treatment protocols.</p>","PeriodicalId":30287,"journal":{"name":"Case Reports in Orthopedics","volume":"2026 ","pages":"1355059"},"PeriodicalIF":0.4,"publicationDate":"2026-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13213915/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148056963","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":"Bisphosphonate-Associated Atypical Femoral Fractures: A Description of Surgical Techniques in the Revision Fixation Setting With an Emphasis on Avoiding Varus Malalignment: A Two-Case Report.","authors":"Aaron Jose Thomas, Ben Murphy, Conor Hurson","doi":"10.1155/cro/9413435","DOIUrl":"10.1155/cro/9413435","url":null,"abstract":"<p><strong>Introduction: </strong>Atypical femoral fractures (AFFs) are insufficiency fractures of the lateral femoral cortex and represent a rare but significant complication of long-term bisphosphonate or denosumab therapy. Our report explores the surgical techniques utilised to avoid varus malalignment in these two complex cases, both of which fulfilled the American Society for Bone and Mineral Research (ASBMR) criteria for AFFs.</p><p><strong>Case presentation: </strong>Case 1 presents a woman in her early 60s with over 8 years of bisphosphonate use, who developed simultaneous AFFs. She underwent bilateral internal fixation with cephalomedullary nails. This was followed by revision surgery and a valgus correction for right femoral fracture nonunion.Case 2 presents a man in his late 60s with prior exposure to bisphosphonates and denosumab (< 7 years), who sustained a left AFF. Initial cephalomedullary nailing was complicated by nonunion and hardware failure, necessitating revision with a valgus correction.</p><p><strong>Conclusion: </strong>Our cases emphasise the importance of recognising symptoms during follow-up assessments and provide a detailed account of the surgical techniques employed in the revision fixation of AFFs, with a particular emphasis on achieving valgus alignment, maintaining a medial entry point and avoiding varus malalignment to optimise mechanical stability, reduce the risk of postoperative nonunion and promote fracture healing.</p>","PeriodicalId":30287,"journal":{"name":"Case Reports in Orthopedics","volume":"2026 ","pages":"9413435"},"PeriodicalIF":0.4,"publicationDate":"2026-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13213072/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148056943","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}