Journal of Orthopaedic Case Reports

INTRODUCTION: Extraforaminal stenosis in L5-S1, or far-out syndrome (FOS), is defined as L5 nerve compression by the transverse process (TP) of the L5 and the ala of the sacrum and disc bulging with/without osteophytes and/or the thickened lumbosacral and extraforaminal ligament. This study aims to describe the unilateral biportal endoscopic decompression technique of the extraforaminal stenosis at L5-S1 or far out syndrome and evaluate its clinical results with a literature review. CASE REPORT: A 44-year-old male presented with severe right sharp shooting pain in the buttock, thigh, leg, foot, and/or toes with numbness in the foot and toes (Visual Analog Scale [VAS] 8/10) for six months with an Oswestry disability index (ODI) score of 70%...

INTRODUCTION: An aneurysmal bone cyst (ABC) is an unusual, non-cancerous bone lesion that is characterized by its lytic (causing bone loss), hemorrhagic, and expanding nature. ABCs are relatively rare, making up only 1% of all bone tumors. These cysts are typically found in long bones and the spine but are very rarely seen in the metatarsal bones, making such occurrences quite uncommon. CASE REPORT: In this case report, we present a case of ABC of the 3rd metatarsal in a 26-year-old female with complaints of long-standing foot pain and gradually increasing swelling of the dorsum of the foot...

INTRODUCTION: Extensor tendon subluxation or dislocation resulting from sagittal band rupture can be associated with snapping, catching, locking, pain, and swelling of the finger. Several etiologies were reported in the literature, with frequent mention of a traumatic rupture caused by a direct blow at the level of the metacarpophalangeal joint (MCPJ). The other causes of sagittal band injuries are degenerative disease, congenital infection, and rheumatoid arthritis. To our knowledge, we report the first case of spontaneous idiopathic bilateral sagittal band rupture...

INTRODUCTION: Variations of the extensor pollicis longus (EPL) tendon of the hand are not uncommon. Yet, this anatomic structure exhibits the least variations among the extensors of the upper extremity. CASE REPORT: This article highlights the presence of an accessory EPL tendon in the fourth dorsal compartment, which was presented as an incidental finding during an elective wrist arthrodesis in a woman in her 40s. CONCLUSION: Knowledge of this anatomic variation can guide surgical planning and mitigate iatrogenic injury by anticipating potential challenges...

INTRODUCTION: Osteoarticular tuberculosis (OATB) contributes to around 10% of extrapulmonary tuberculosis of which the spine is the most common site. Isolated involvement of ulna diaphysis is extremely rare. We present a case of unifocal tuberculous osteomyelitis of ulna diaphysis in a 3 -year-old male child and highlight its resemblance with musculoskeletal tumors and stress the importance of GeneXpert mycobacterium tuberculosis (MTB)/resistance to rifampicin (RIF) in the diagnosis of OATB...

No abstract text is available yet for this article.

INTRODUCTION: The prognosis for toe fractures with coalition is generally good, but in some cases, bone union may not be achieved. This is the report in which good results are obtained by surgery for a painful delayed union of biphalangeal toe fractures. CASE REPORT: Case 1: A 64-year-old Japanese woman had left toe pain for 7 months. Plain radiography showed fourth toe fracture with coalition. Surgical fixation was performed. Case 2: A 63-year-old Japanese woman had left toe pain for a month...

INTRODUCTION: A difficult pattern of injuries is Hotchkiss's terrible triad, which includes elbow dislocations with fracture of the coronoid and head of radius. It is uncommon to have a concurrent proximal humerus fracture, which makes clinical care even more difficult. CASE REPORT: An injured worker, 33 years old, claimed to have fallen from a height and received several injuries when he arrived at our emergency center. On physical examination, the patient showed signs of deformity and had an open injury over his left elbow...

INTRODUCTION: We encountered a unique case of a patient with two distinct tumors coexisting in the same thigh. To the best of our knowledge, this combination of tumors in the same anatomical region has not been previously described in the literature. CASE REPORT: This case report describes a 38-year-old Caucasian male with a painless mass in his right thigh, which was later diagnosed as a hybrid tumor composed of low-grade fibromyxoid sarcoma and sclerosing epithelioid fibrosarcoma, as well as a second tumor, which was diagnosed as a hibernoma...

INTRODUCTION: Tuberculosis (TB) is a global public health problem, endemic to India. Osteoarticular TB uncommonly presents in the foot, navicular osteomyelitis is an extremely rare entity. CASE REPORT: We report a rare case of navicular osteomyelitis caused by TB in a 37-year-old man who presented to OPD with swelling and dull aching pain over the dorsum of his left foot. A radiograph of the foot showed a lytic lesion in the navicular bone. Further investigations in the form of aspiration cytology, cartridge-based nucleic acid amplification test, and acid-fast bacilli culture confirmed TB...

No abstract text is available yet for this article.

INTRODUCTION: Numerous reflexive responses have been documented as alterations to the Babinski sign within upper motor neuron lesions. However, scant attention has been given to reflexes beyond these, which exhibit independence from the extensor plantar response. These reflexes predominantly form polysynaptic arcs, with nociceptive stimuli acting as afferents. CASE REPORT: The reflex was serendipitously discovered in an 18-year-old female patient who presented with spastic paraplegia with bowel and bladder involvement, as a consequence of an aneurysmal bone cyst of the D3 (dorsal) vertebrae, and the same was named after the authors as "Yadav-Kunal reflex" which can be defined as: "In individuals with spastic paraparesis, forcibly plantarflexing the toes will result in sudden jerky flexion of the knee and hip on the same side...

INTRODUCTION: The femoral neck system (FNS) represents an emerging fixation system designed for the management of femoral neck fractures. This innovative system combines the mechanical benefits of compression and anti-rotation properties in internal fixation. Biomechanical studies have demonstrated the superior axial and rotational stability of the FNS implant when compared to traditional cannulated screws and dynamic hip screw. Despite these promising mechanical advantages, there is currently a limited body of literature addressing the factors contributing to FNS failure...

INTRODUCTION: Juvenile idiopathic arthritis ( JIA) is a persistent autoimmune-inflammatory disease that affects children younger than 16. Aggressive synovitis of the hip may cause joint destruction, hip protrusion, erosion, pseudosubluxation, dysplasia, and osteoarthritis. Subluxation of the hip had been reported previously. However, dislocation of the hip in JIA is an extremely rare situation, and only two cases have been reported up to date. Reduction of the dislocated hip has to be performed in any way...

BACKGROUND: Intra-articular and periarticular distal femur fractures with pre-existing osteoporosis (OP) and osteoarthritis (OA) pose a significant challenge to ambulatory patients because of the higher chances of implant failure and severe disability of OA. To reduce OA-related morbidity, we advocate simultaneous total knee arthroplasty (TKA) with fracture fixation instead of fracture fixation alone using computer-assisted navigation to achieve proper ligament balance, restoration of the mechanical axis, and component alignment...

INTRODUCTION: Non-ossifying fibroma (NOF) is a common benign fibrogenic bone lesion commonly found in the metaphysis of long bones. While small NOFs are typically asymptomatic and left untreated, large NOFs are often associated with pathologic fractures that can be treated conservatively or operatively. To our knowledge, the NOF presented in this case report is one of the largest reported in the literature. CASE REPORT: We present a case of a 12-year-old Hispanic female who presented to our institution after falling off a horse and landing on her right leg and wrist...

INTRODUCTION: Bilateral Sprengel deformities, mirror movements synkinesis, and arthrogryposis are described in different combinations in various syndromes but never together. CASE REPORT: We present a 12-year-old girl who presented with bilateral shoulder deformities and difficulty in coordination while writing. On examination, she was noted to have bilateral Sprengel deformities with flexion contractures of upper-limb joints and mirror movements of both upper and lower-limb joints...

INTRODUCTION: Transient osteoporosis of the hip (TOH) is a poorly recognized self-limiting clinical entity. Due to a lack of awareness among the clinicians, the condition is often misdiagnosed leading to inappropriate treatment, thereby lengthening the time to diagnosis (TTD). In this study, we analyze the delay in TTD of TOH using plain radiographs and present the optimal management strategy. CASE REPORT: We retrospectively collected the data of patients who were diagnosed with TOH from March 2017 to March 2022...

INTRODUCTION: Unilateral subchondral insufficiency fractures (SIF) of the femoral head have been reported in many cases; however, bilateral cases occurring simultaneously are very rare. CASE REPORT: We report two cases of relatively active elderly females (aged 73 and 67 years), in which bilateral hip pain appeared simultaneously without any specific triggers. There were no notable lifestyle or medication histories. Imaging and histopathology of the bone excised surgically supported the diagnosis...

INTRODUCTION: Pre-extensively drug-resistant tuberculosis (TB) is characterized by resistance to either a fluoroquinolone (FQ) or a second-line injectable but not both. The urgent need for prompt diagnosis and targeted treatment is emphasized. This report aims to spotlight a case of spinal TB with insufficient assessment, resulting in delayed definitive treatment and an oversight contributing to heightened morbidity. CASE REPORT: An 18-year-old female who was initially diagnosed to have multidrug-resistant TB leading to a 2-year treatment which eventually resulted in multifocal involvement of the spine revealing TB relapse with FQ resistance, categorized as pre-extensively drug-resistant TB...