Journal of Musculoskeletal Trauma

Articles in E-pub version are posted online ahead of regular printed publication.

Case Reports

Surgical management of a displaced proximal fibular fracture with peroneal nerve injury in Korea: a case report: Sang-Gon Kim, Sang-Heon Oh, Ki-Bong Park; Received May 15, 2026 Accepted July 1, 2026 Published online September 21, 2026; DOI: https://doi.org/10.12671/jmt.2026.00213 [Epub ahead of print]

Abstract PDF: This case report describes a rare inferomedially displaced proximal fibular fracture associated with acute common peroneal nerve injury in a 73-year-old man after an industrial crush injury. The patient presented with severe knee pain and a subjective sensory deficit on the dorsum of the right foot. Given the marked inferomedial displacement of the fracture fragment and the associated neurological symptoms, surgical intervention was selected to achieve anatomical reduction and permit direct nerve assessment. After four days of soft-tissue management, open reduction and internal fixation were performed via a posterior approach with the patient in the prone position. The fragment was securely fixed with 4.5-mm cannulated screws, and nerve exploration confirmed mild nerve sheath injury without complete disruption; therefore, neurorrhaphy was not required. This case illustrates that operative intervention may be considered in selected patients with markedly inferomedially displaced proximal fibular fractures, particularly when acute neurological deficits are present. In this specific displacement pattern, a posterior approach in the prone position may provide a useful surgical option for achieving anatomical reduction while allowing direct neurovascular protection. Level of evidence: V.

559 View
4 Download

Same-site recurrence of an incomplete atypical femoral fracture 8 years after prophylactic intramedullary nailing following bisphosphonate re-exposure in an 81-year-old woman in Korea: a case report: Youngho Cho, Changhun Lim; Received May 31, 2026 Accepted July 1, 2026 Published online September 21, 2026; DOI: https://doi.org/10.12671/jmt.2026.00227 [Epub ahead of print]

Abstract PDF: An 81-year-old woman with osteoporosis presented in April 2024 with recurrent right thigh pain, 8 years after prophylactic intramedullary nailing for an incomplete atypical femoral fracture (AFF) in February 2016. She had a history of bisphosphonate use for approximately 10 years followed by a 5-year drug holiday and three ibandronate infusions before the index fracture in 2016; after a subsequent 4-year antiresorptive-free interval, bisphosphonate therapy was resumed in 2020–2021 following a new vertebral compression fracture. Plain radiographs in 2024 showed recurrent lateral cortical thickening and a transverse radiolucent line at the same site as the previous lesion, with intact hardware. Bone scintigraphy confirmed intense uptake consistent with a recurrent stress reaction. Laboratory testing showed markedly suppressed bone turnover markers, with a serum β-isomerized C-terminal telopeptide of type I collagen (β-CTX) level of 0.048 ng/mL, below the lower limit of the reference range (0.112 ng/mL). The lesion healed during conservative management consisting of bisphosphonate discontinuation, calcium and vitamin D supplementation, retained mechanical stabilization, and a 4-month course of off-label teriparatide. The independent contribution of teriparatide cannot be determined from this single case. This case highlights the rare phenomenon of same-site incomplete AFF recurrence long after prophylactic fixation in association with bisphosphonate resumption and describes successful conservative healing with short-term teriparatide in the presence of preexisting hardware. Level of evidence: V.

300 View
1 Download

First
Prev
Page of 1
Next
Last

Ahead-of print articles