Reports (MDPI)Pub Date : 2025-06-19DOI: 10.3390/reports8020098
James Hall, Hasnayn Raza, Sarah Lee, Nicole Bryce, Sunil Abrol
{"title":"Successful Treatment of Left Ventricle Inferior Wall Perforation and Rupture Associated with an Impella 5.5: A Case Report.","authors":"James Hall, Hasnayn Raza, Sarah Lee, Nicole Bryce, Sunil Abrol","doi":"10.3390/reports8020098","DOIUrl":"10.3390/reports8020098","url":null,"abstract":"<p><p><b>Background and Clinical Significance:</b> Perforation of the left ventricle related to microaxial ventricular assist devices (Impella) is a rare but fatal complication related to placement or adjustment. It results in left ventricular hemorrhage and tamponade, leading to rapid deterioration and death. <b>Case Presentation:</b> We present a case report of a 73-year-old man who developed this complication postoperatively and was successfully managed to a full recovery. <b>Conclusions:</b> To our knowledge, he is the only reported patient to have this complication outside the setting of immediate placement who subsequently survived to discharge.</p>","PeriodicalId":74664,"journal":{"name":"Reports (MDPI)","volume":"8 2","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12197156/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144710208","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}
Reports (MDPI)Pub Date : 2025-06-18DOI: 10.3390/reports8020095
Alexandru Cristian Cindrea, Adina Maria Marza, Alexandra Maria Borita, Antonia Armega-Anghelescu, Ovidiu Alexandru Mederle
{"title":"Case Report: Spontaneous Pneumomediastinum and Pneumothorax Complicating Severe Ketoacidosis-An Unexpected Presentation.","authors":"Alexandru Cristian Cindrea, Adina Maria Marza, Alexandra Maria Borita, Antonia Armega-Anghelescu, Ovidiu Alexandru Mederle","doi":"10.3390/reports8020095","DOIUrl":"10.3390/reports8020095","url":null,"abstract":"<p><p><b>Background and Clinical Significance:</b> Diabetic ketoacidosis (DKA) is a serious and potentially life-threatening condition, often triggered by infections or undiagnosed diabetes. Spontaneous pneumomediastinum (SPM) and pneumothorax are rare but recognized complications of DKA, possibly due to alveolar rupture from increased respiratory effort or vomiting. Sometimes, acute pancreatitis (AP) may further complicate DKA, but the co-occurrence of these three conditions remains exceptionally rare. <b>Case Presentation:</b> We describe the case of a 60-year-old woman without a known history of diabetes who arrived at the emergency department with abdominal pain, fatigue, vomiting, and altered mental status. Initial laboratory findings showed metabolic acidosis, hyperglycemia, and elevated anion gap, consistent with DKA. Imaging revealed spontaneous pneumomediastinum and subsequently a left-sided pneumothorax, without evidence of trauma or esophageal rupture. Epigastric pain, along with elevated serum lipase and CT findings, also confirmed acute pancreatitis. Despite the complexity of her condition, the patient responded well to supportive treatment, including oxygen therapy, fluid resuscitation, insulin infusion, and antibiotics. She was discharged in good condition after 28 days, with a confirmed diagnosis of type 2 diabetes, without further complications. <b>Conclusions:</b> This case highlights an unusual combination of DKA complicated by spontaneous pneumomediastinum, pneumothorax and acute pancreatitis in a previously undiagnosed diabetic patient. Because prompt intervention can lead to favorable outcomes even in complex, multisystem cases, early recognition of atypical DKA complications is critical in order to avoid misdiagnosis.</p>","PeriodicalId":74664,"journal":{"name":"Reports (MDPI)","volume":"8 2","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12197081/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144710191","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}
Reports (MDPI)Pub Date : 2025-06-18DOI: 10.3390/reports8020096
Jacquelyn Shugarts, Aida Amado, Taylor Praska, Monica Camou, Jiaxin Niu
{"title":"Treatment of Leptomeningeal Disease with Tepotinib in a Patient with Lung Adenocarcinoma Harboring MET Exon 14 Skipping Mutation Presenting with Extensive Metastasis Involving Duodenum.","authors":"Jacquelyn Shugarts, Aida Amado, Taylor Praska, Monica Camou, Jiaxin Niu","doi":"10.3390/reports8020096","DOIUrl":"10.3390/reports8020096","url":null,"abstract":"<p><p><b>Background and Clinical Significance:</b> The mesenchymal-epithelial transition (MET) exon 14 skipping mutation (METex14) is a rare genetic alteration occurring in non-small cell lung cancer (NSCLC). Tyrosine kinase inhibitors (TKIs) are the approved treatment for first-line therapy in a metastatic setting. However, the unusual presentation of gastrointestinal metastasis and leptomeningeal carcinomatosis (LMD) poses significant treatment challenges. <b>Case Presentation</b>: Here we report a case of a 72-year-old male with metastatic METex14-positive NSCLC, presenting with brain and duodenal metastases. <b>Conclusions</b>: The patient responded exceptionally well to first-line chemoimmunotherapy, achieving clinically complete remission for 2 years. He subsequently developed cerebellar metastasis and leptomeningeal disease (LMD) but demonstrated a remarkable response to tepotinib and continued to enjoy radiographic complete remission over 2.5 years at the time of this report.</p>","PeriodicalId":74664,"journal":{"name":"Reports (MDPI)","volume":"8 2","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12196619/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144710225","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":"The First Percutaneous Closures of Patent Ductus Arteriosus in Premature Neonates in Serbia: A Case Report Series.","authors":"Stasa Krasic, Branislav Mojsic, Vladislav Vukomanovic","doi":"10.3390/reports8020097","DOIUrl":"10.3390/reports8020097","url":null,"abstract":"<p><p><b>Background and Clinical Significance:</b> The incidence of persistent ductus arteriosus (PDA) in preterm infants is the highest and depends on their birth weight (BW) and respiratory condition after birth. Previously, after the unsuccessful drug treatment, surgical ligation was the primary treatment option. However, according to clinical studies, the Amplatzer Piccolo Occluder was approved for PDA closure for patients ≥700 g. In our country, percutaneous PDA embolization has not been performed yet. <b>Case Presentation:</b> We present three premature infants with hemodynamically significant patent ductus arteriosus (hsPDA) in whom percutaneous occlusion was performed using the Amplatzer Piccolo Occluder (APO). The average gestational week (GW) was 27 ± 1, while body weight was 1030 ± 60 g. All patients had respiratory deterioration, with dilatation of the left heart chambers, and renal failure. The second developed a severe form of broncho-pulmonary dysplasia. Transthoracic echocardiography (TTE) examinations revealed a hemodynamically significant PDA (LA/Ao 1.8-2.2) and medical closure was unsuccessfully carried out. Due to the hemodynamically significant PDA maintenance in all neonates, transvenous PDA closure was performed using the APO (APO 9-PDAP-04-02-L, 9-PDAP-04-04-L, 9-PDAP-05-054L, respectively). The entire devices, with both retention discs, are implanted within the duct. TTE pointed out adequate device position without descending aorta, left pulmonary artery obstruction, residual shunt, and reverse remodelling of the left ventricle and left atrium. The first newborn was weaned from mechanical ventilation three days after the procedure and discharged three weeks after. The second patient was extubated 2 weeks after the procedure, and even the severe BPD, X-ray showed improvement. The third patient's renal failure completely resolved, weaned from inotropic drug support and mechanical ventilation. <b>Conclusions</b>: Due to a significantly lower complication rate than surgical ligation, we will strive to make percutaneous PDA occlusion a new standard for treatment in newborns, especially preterm newborns, in our country.</p>","PeriodicalId":74664,"journal":{"name":"Reports (MDPI)","volume":"8 2","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12196642/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144710220","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}
Reports (MDPI)Pub Date : 2025-06-14DOI: 10.3390/reports8020094
Samantha Lo, Sanjay Sivalokanathan, Nina Kukar
{"title":"Unraveling Mitral Annular Disjunction: A Case Report of Ventricular Arrhythmia Detected via Smartwatch.","authors":"Samantha Lo, Sanjay Sivalokanathan, Nina Kukar","doi":"10.3390/reports8020094","DOIUrl":"10.3390/reports8020094","url":null,"abstract":"<p><p><b>Background and Clinical Significance:</b> Mitral valve prolapse (MVP) is commonly benign, but may result in life-threatening arrhythmias and sudden cardiac death (SCD). Mitral annular disjunction (MAD) often coexists with mitral valve prolapse (MVP) and has been implicated in the development of ventricular arrhythmias through myocardial stretch and fibrosis. <b>Case Presentation:</b> Here, we present a case that highlights the diagnostic value of multimodal imaging in evaluating ventricular ectopy in the context of MVP and MAD. A 72-year-old male presented to the cardiology clinic with palpitations and fatigue, compounded by an arrhythmia identified by his Apple Watch. Holter monitoring revealed premature ventricular contractions (PVCs), with cardiac magnetic resonance imaging (CMR) demonstrating MAD and basal inferolateral scarring. Despite minimal symptoms and normal echocardiographic imaging, CMR findings highlight the utility of advanced cardiovascular imaging in patients with newly detected ventricular arrhythmias. <b>Conclusion:</b> This case highlights the importance of integrating consumer wearables and advanced imaging in evaluating ventricular ectopy and its evolving role in risk stratification for patients with MVP, even in the absence of overt symptoms.</p>","PeriodicalId":74664,"journal":{"name":"Reports (MDPI)","volume":"8 2","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12197234/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144710228","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}
Reports (MDPI)Pub Date : 2025-06-11DOI: 10.3390/reports8020093
Andrew Horan, Stephen Kellett, Chris Gaskell, Conor Morris
{"title":"Cognitive Analytic Therapy for Functional/Dissociative Seizures in an Adolescent: Case Report and Mixed-Methods Single-Case Evaluation.","authors":"Andrew Horan, Stephen Kellett, Chris Gaskell, Conor Morris","doi":"10.3390/reports8020093","DOIUrl":"10.3390/reports8020093","url":null,"abstract":"<p><p><b>Background and clinical significance</b>: Functional/dissociative seizures (FDSs) in adolescents are paroxysmal events which superficially resemble epileptic seizures or syncope. This study evaluated the effectiveness of brief cognitive analytic therapy (CAT). <b>Case presentation</b>: The patient was a 17-year-old white cisgender male with a diagnosis of non-epileptic attack disorder. The functional/dissociative seizures were treated with 8-session CAT, with follow-up at 5 weeks. Two target problems (TPs) and associated target problem procedures (TPPs) were rated for recognition and revision at each session and at follow-up. An A-B-C-FU single-case experimental evaluation of the TP/TPPs was conducted. Nomothetic outcome measures (DES-2 and RCADS) were administered at session 1, session 8, and at follow-up, and the YP-CORE and the Session Rating Scale were completed at each session. The patient was independently interviewed using the Change Interview 13 weeks after completing therapy. The results show that CAT effectively increased the recognition and revision of TPs/TPPs, four specific changes occurred (including cessation of functional seizures). There were pre-post reliable and clinically significant improvements to psychological wellbeing, but these were not maintained at follow-up. <b>Conclusions</b>: This study indicates that CAT was a partially effective intervention. The use of CAT as a treatment for FND in adolescents holds promise, but more research is needed.</p>","PeriodicalId":74664,"journal":{"name":"Reports (MDPI)","volume":"8 2","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12196643/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144710193","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}
Reports (MDPI)Pub Date : 2025-06-09DOI: 10.3390/reports8020092
Pedro Christian Aravena, Mario E Flores, Larissa Córdova Turones, Francisca Pavicic, Pamela Ehrenfeld
{"title":"Alveolar Ridge Preservation Using Three-Dimensional Root Replicas of Polycaprolactone: A Radiological and Histological Evaluation of a Case Report.","authors":"Pedro Christian Aravena, Mario E Flores, Larissa Córdova Turones, Francisca Pavicic, Pamela Ehrenfeld","doi":"10.3390/reports8020092","DOIUrl":"10.3390/reports8020092","url":null,"abstract":"<p><p><b>Background and Clinical Significance:</b> To describe the effectiveness of alveolar ridge preservation under the radiological and histological analysis of a customized resorbable scaffold three-dimensionally printed with polycaprolactone (PCL) reinforced with a coating of a copolymer of polycaprolactone-block-polyethylene glycol (PCL-PEG) by electrospray. <b>Case Presentation:</b> A 62-year-old male with vertical root fractures of teeth #14 and #15. From the cone beam CT (CBCT) image, the scaffold root replicas were designed with the shape of the roots and printed with PCL coated with PCL-PEG by electrospray. The scaffold was inserted into the alveolar bone and maintained with a tension-free flap closure. After six months, a CBCT of the surgical site and histological analysis of a bone sample at the dental implant installation site were performed. After 6 months, the wound in tooth #14 was closed, clinically proving no adverse reaction or complications. The histological analysis of the bone sample showed new bone formation with lamellar structure, Haversian canal structure, and osteocyte spaces. However, the scaffold in tooth #15 was exposed and not osseointegrated, and it was covered with membranous tissue. Histologically, the sample showed tissue compatible with lax connective tissue with mixed inflammatory infiltrate. In tooth #14, the dental implant presented an insertion torque >35 Ncm and was rehabilitated three months after its installation. <b>Conclusions:</b> Three-dimensional printed PCL scaffolds showed the ability to regenerate vital and functional bone with osseointegration capability for maxillary bone regeneration and oral rehabilitation based on dental implants. A case of inadequate scaffold osseointegration accompanied by lax connective tissue formation is shown.</p>","PeriodicalId":74664,"journal":{"name":"Reports (MDPI)","volume":"8 2","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12196692/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144710185","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}
Reports (MDPI)Pub Date : 2025-06-07DOI: 10.3390/reports8020091
Franciszek Ługowski, Aleksandra Urban, Joanna Kacperczyk-Bartnik, Ewa Janowska, Jacek Sieńko
{"title":"Successful Management of Cervical Ectopic Pregnancy with Methotrexate in a Nulliparous Woman: A Case Report.","authors":"Franciszek Ługowski, Aleksandra Urban, Joanna Kacperczyk-Bartnik, Ewa Janowska, Jacek Sieńko","doi":"10.3390/reports8020091","DOIUrl":"10.3390/reports8020091","url":null,"abstract":"<p><p><b>Background and Clinical Significance:</b> Implantation of an embryo in the cervical canal is the rarest location of ectopic pregnancy, as it occurs between 1 in 1000 and 1 in 18,000 pregnancies. Dilation and curettage in previous pregnancies have been identified as risk factors in most cases. Other predisposing factors include pelvic inflammatory disease (PID), prior tubal surgeries, assisted reproductive technologies, as well as the presence of fibroids and intrauterine. Importantly, ectopic pregnancies are the main cause of maternal morbidity and mortality in the first trimester. Given the rarity of cervical ectopic pregnancies (CEPs) and the lack of specific recommendations, clinical data supporting current evidence is of utmost significance. <b>Case Presentation:</b> A 29-year-old nulliparous woman presented with spotting from the genital tract and lower abdominal pain persisting for four days. Pregnancy could not be ruled out based on the patient's medical history. The level of β-Human chorionic gonadotropin (β-HCG) on admission was 1487.99 mIU/mL. The first ultrasonography examination revealed a non-specific imaging appearance suggestive of the presence of cervical mucus. Targeted examination with visualization of the cervical canal revealed a gestational sac measuring 4-5 mm in diameter, containing an embryonic echo. The patient was treated with 84 mg of methotrexate (MTX) i.v. in a 1, 3, 5, 7 scheme along with 0.1 mg/kg calcium folinate i.m. in a 2, 4, 6, 8 scheme prior to curettage. <b>Conclusions:</b> A diagnosis of cervical pregnancy cannot be excluded even in the absence of prior risk factors. Methotrexate should be considered a safe and efficient option in the management of CEP. As shown in our case, early detection of CEP is of utmost significance.</p>","PeriodicalId":74664,"journal":{"name":"Reports (MDPI)","volume":"8 2","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12196641/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144710206","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}
Reports (MDPI)Pub Date : 2025-06-06DOI: 10.3390/reports8020090
Nicole Piber, Christian Nöbauer, Bernhard Voss, Markus Krane, Stephanie Voss
{"title":"An Unexpected Finding of a Papillary Fibroelastoma in the Left Ventricle of an Asymptomatic Patient-A Case Report.","authors":"Nicole Piber, Christian Nöbauer, Bernhard Voss, Markus Krane, Stephanie Voss","doi":"10.3390/reports8020090","DOIUrl":"10.3390/reports8020090","url":null,"abstract":"<p><p><b>Background and Clinical Significance:</b> Papillary Fibroelastoma is a benign primary cardiac tumor, commonly located in a valvular position, predominantly on the aortic valve. <b>Case Presentation</b>: We present a 73-year-old male patient with a medical history of chronic lymphatic leukemia, kidney failure, diabetes, and obstructive sleep apnea. In a routinely performed echocardiogram an abnormal structure in the left ventricle was found. The patient presented completely asymptomatically at the time of examination. A cardiac magnetic resonance-scan provided further information about the size and localization of the tumor in the left ventricle, which seemed to be attached to a papillary muscle and was about 1.6 cm in diameter. Due to visible scarring of the myocardia, which was identified in the scan, a cardiac catheter examination was performed. A coronary artery disease was detected with a severe stenosis in three vessels. During an elective bypass-operation, the removal of the structure was performed with an approach through the left atrium, passing the mitral valve using a valve sizer for better exposure. The tumor of 1 cm presented macroscopically with an anemone-like shape. The histopathological examination confirmed the intraoperative assumption of a papillary fibroelastoma, found in an aberrant location. <b>Conclusions</b>: Unexpectedly challenging surgical removals of structures in the left ventricle require innovative techniques with available instruments for better exposure.</p>","PeriodicalId":74664,"journal":{"name":"Reports (MDPI)","volume":"8 2","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12196758/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144710188","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}
Reports (MDPI)Pub Date : 2025-06-05DOI: 10.3390/reports8020089
Ana Del Potro Jareño, Alfonso González Menocal, Ana Antonia Couceiro Laredo, Laura Conde Ruiz, Daniel López Dorado
{"title":"A Longitudinal Peri-Implant Diaphyseal Fracture Around a Locked Humeral Nail: A Case Report.","authors":"Ana Del Potro Jareño, Alfonso González Menocal, Ana Antonia Couceiro Laredo, Laura Conde Ruiz, Daniel López Dorado","doi":"10.3390/reports8020089","DOIUrl":"10.3390/reports8020089","url":null,"abstract":"<p><p><b>Background and Clinical Significance</b>: Non-prosthetic peri-implant fractures (NPPIFs) are rare injuries occurring around internal fixation devices, and are distinct from periprosthetic fractures. While most studies focus on the femur, humeral NPPIFs remain poorly documented. This case illustrates a complex humeral NPPIF and highlights key surgical considerations. <b>Case Presentation</b>: A 62-year-old woman presented with a spiral humeral shaft fracture (AO 12B2) after a fall. Following closed reduction and antegrade intramedullary nailing, an intraoperative peri-implant fracture occurred at the distal interlocking screw. CT imaging revealed a complex fracture extending from the lateral condyle to the proximal humerus. Treatment included implant removal and open reduction with dual plate fixation-lateral distal and helically contoured proximal plates-plus cerclage bands and antibiotic-loaded beads. Recovery was uneventful, with a full range of motion achieved at six months. At one year, the DASH score and MEPS were 86 and 75, respectively. <b>Conclusions</b>: Humeral NPPIFs are challenging and require individualized, biomechanically sound strategies. This case reinforces the importance of intraoperative assessment and careful implant selection in humeral fracture management.</p>","PeriodicalId":74664,"journal":{"name":"Reports (MDPI)","volume":"8 2","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12196821/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144710180","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}