Journal of Orthopaedic Case Reports

INTRODUCTION: Simultaneous bilateral anterior cruciate ligament (ACL) ruptures are rare, especially in the pediatric population, with very limited evidence. We aimed to review the current literature and present a case study of an adolescent patient who underwent bilateral reconstruction with hamstrings autograft in a single-stage with a partial transphyseal "all-inside" technique. LITERATURE REVIEW: The limited evidence reports that the incidence of growth disturbance following ACL reconstruction in the skeletally immature is 2...

INTRODUCTION: Literature showcases conflicting findings regarding the outcomes of ballistic fragment removal from the spine in gunshot wounds (GSW) patients. Further research in this area is needed to better comprehend the nuances of risks and benefits surrounding ballistic fragment removal from the spine in GSW patients. In this case report, we discuss the late-onset cervical prevertebral abscess which developed when a previously embedded bullet fragment migrated into the retropharyngeal space 11 years after an initial GSW...

INTRODUCTION: A stress fracture is a painful condition which occurs when the adaptive ability of the bone is unbalanced. This imbalance predominantly occurs due to increased intensity, frequency, or duration of training. Identifying the etiology of stress fracture and its proper treatment prevents recurrence. Besides, evidence-based and supervised rehabilitation is indispensable for permanent remission of pain and return to sports to preinjury functional levels. The case series discusses the continuum of stress reaction to stress fracture in athletes, causes of stress fractures, their management, and return to sport...

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INTRODUCTION: Fracture-dislocations of the proximal interphalangeal joint (PIPJ) can have a significant impact on digital motion and hand function if inappropriately treated. While these injuries are commonly encountered, they can be quite challenging to manage. It is critical to ensure a concentric reduction and early motion when treating these injuries. CASE REPORT: A 17-year-old woman sustained a fracture-dislocation of the PIPJ of the left small finger. Despite a concentric closed reduction, she had pain and a mechanical block to PIPJ motion...

Today, the total knee replacement (TKR) is considered as one of the most successful orthopedics surgeries. The effective long-term pain relief, deformity correction, and restoration of function that it provides have resulted in a large number of these procedures being performed worldwide. It has been observed that 15-20% of patients are not satisfied even after successful TKR surgery. Various attempts such as careful patient selection, pre-operative education, optimization of patients before the surgery, expeditious and precise surgery, aggressive pain control, early return to home, and rehabilitation have been made to improve outcomes and satisfaction among patients...

INTRODUCTION: The management of hip dislocation in patients older than 9 years of age is a challenge in terms of deciding which is the best treatment course to follow since the main sequelae are as follows: pain, discrepancy in the length of the pelvic extremities and lame gait, with the consequent disability for activities of daily living. In Ho Choi, Thabet A mention limited treatment options, including total hip arthroplasty and hip arthrodesis. These options have their benefits and limitations...

INTRODUCTION: Closed anatomical reduction of per-trochanteric fractures requires 3-axis control of the orthopedic traction table (OTT) which is challenging in patients having suffered a previous ipsilateral Gritti-Stokes amputation. CASE REPORT: A 52-year-old man, known by Gritti-Stokes amputated (GSA) 10 years before, was admitted to our trauma center after a fall from his height. We describe a simple method for positioning a previously ipsilateral GSA patient in an OTT to reduce displaced a femoral per-trochanteric fracture site and to maintain it during surgery...

INTRODUCTION: Intramuscular myxomas are rare, benign mesenchymal tumors which commonly arise in muscle of the upper limb, pelvis, abdominal tissue, spine, or facial muscle. There are few case reports of intramuscular myxomas, and none of these describe intramuscular myxoma as a cause of compressive neuropathy. CASE REPORT: We describe the case of a 67-year-old woman who presented to us with a 1-year history of progressive enlargement of a painless right elbow mass...

INTRODUCTION: Commonly, cervicogenic headache (CGH) pathology originates from the upper cervical nerve ranging from C1-C3, with C2-C3 most frequently involved. The pathophysiology and etiology of this syndrome have been the subject of ongoing controversy in the past decade. Most literature regarding CGH, mainly research about relationship between upper cranial nerves (C1-C3) indicating that the possibility it originates from other cervical levels is poorly understood. CASE REPORT: A 64-year-old man arrived with a 6-month history of occiput pain, followed by severe shooting pain in both arms, with a greater intensity on the right side...

INTRODUCTION: Prolonged phenytoin (PHD) therapy in epileptics predisposes patients to deleterious effects on bone health causing osteoporosis; however, despite its known effect on wound healing, collagen and fibroblast proliferation, and osteogenic differentiation, its impact on fracture healing remains poorly researched, we, report two cases of early exuberant callus formation in long bone fractures in patients undergoing long-term PHD therapy. CASE REPORT: Two female patients with known seizure disorder on long-term PHD therapy experienced proximal humerus fractures after trivial trauma...

INTRODUCTION: Surgical treatment of bilateral traumatic sternoclavicular (SC) joint dislocations has never been reported in the literature. In the acute setting, posterior dislocation can present with a host of comorbidities due to structures that lie in close proximity posterior to the medial clavicle. CASE REPORT: This study presents a case of bilateral traumatic posterior SC joint dislocation with associated brachiocephalic injury that was treated with open reduction and surgical stabilization...

INTRODUCTION: Tuberculosis (TB) remains a pervasive infectious disease, and extrapulmonary manifestations account for a significant proportion of cases. Skeletal involvement is observed in about 10% of extrapulmonary TB instances. While spinal TB is relatively common, sacroiliac (SI) joint TB is a rare occurrence, particularly in immunocompetent individuals. CASE REPORT: This case report discusses an unusual presentation in a 19-year-old immunocompetent lady where the spine, acetabulum, and SI joint were concurrently affected...

INTRODUCTION: Enchondroma is a cartilaginous benign tumor of bone with the most common involvement of tubular bones of hands and feet. The triquetrum and pisiform are carpal bones and the enchondroma of the triquetrum and pisiform has not been reported in the literature to the best of our knowledge. CASE REPORT: A 26-year-old male presented with swelling over his right wrist with painful terminal motion. Based on magnetic resonance imaging findings, diagnosis of enchondroma of triquetrum and pisiform was made...

INTRODUCTION: Fixed flexion deformity (FFD) following total knee arthroplasty occurs in approximately 4% of patients undergoing primary total knee arthroplasty. Treatment modalities for significant disabling FFD post-arthroplasty encompass manipulation under anesthesia, osteophyte resection, soft tissue release, peroneal nerve decompression, and revision knee replacement. CASE REPORT: A 43-year-old lady, a known case of rheumatoid arthritis and psoriasis, presented with fixed flexion contracture of the left knee following total knee arthroplasty...

INTRODUCTION: Anterior cruciate ligament (ACL) reconstruction is a common orthopedic procedure, employing various grafts such as the hamstring tendon, bone-patellar bone, and quadriceps tendon. Fixation methods include suspensory loop with button, interferential screw, and cortical fixation. The optimal screw diameter for tibial tunnel fixation remains undefined, with choices ranging from 1mm smaller to 1-2 mm larger than the tunnel diameter. Screw-related complications such as breakage and thread flattening are concerns...

INTRODUCTION: Morel-Lavallée lesion (MLL) is a closed degloving injury that occurs after traumatic damage to soft tissue, leading to the formation of an encapsulated serosanguinous collection of fluid. Although some MLLs resolve spontaneously, chronic MLLs present with a significant risk of infection and may impede patients' quality of life. Chronic lesions require surgical intervention to evacuate and debride the hematoma, often resulting in severe cosmetic damage postoperatively...

INTRODUCTION: Distal radius fractures account for nearly one-third of all pediatric fractures, making it among the most common of all pediatric fractures. Studies report that distal radius physeal arrest rates following trauma to the distal radius seem to occur in only about 5% of patients. Significant ulnar variance can develop leading to notable pain and limitations in function. CASE REPORT: We present a case of a 17-year-old right-hand dominant adolescent Caucasian male with persistent ulnar wrist pain...

INTRODUCTION: Long-term bisphosphonate (BP) administration may cause an atypical femoral fracture that is occasionally bilateral. We encountered a case of an impending atypical femoral fracture on the contralateral side that progressed to a complete fracture early after surgery for an atypical femoral fracture. CASE REPORT: An 83-year-old woman who had received long-term BP therapy developed a right femoral atypical incomplete fracture that progressed to a complete fracture 5 days after surgery for an atypical complete left femoral fracture...

INTRODUCTION: Pan-labral tears, commonly associated with recurrent shoulder dislocations, are a well-documented pathology. However, circumferential pan-labral tears following a first-time shoulder dislocation represent a rare and scarcely reported entity in the literature. Accurate diagnosis requires a comprehensive clinical history, physical examination, and further evaluation, often involving MRI. Even with advanced imaging, the acute nature of the injury can lead to the oversight of pan-labral tears, necessitating arthroscopic assessment for definitive diagnosis...