{"id":"https://openalex.org/W7204252199","doi":"https://doi.org/10.12659/ajcr.953196","title":"A High-Energy Military Femoral Fracture With Multidrug-Resistant Infection: A Case Report","display_name":"A High-Energy Military Femoral Fracture With Multidrug-Resistant Infection: A Case Report","publication_year":2026,"publication_date":"2026-08-26","ids":{"openalex":"https://openalex.org/W7204252199","doi":"https://doi.org/10.12659/ajcr.953196","pmid":"https://pubmed.ncbi.nlm.nih.gov/42837321","pmcid":"https://www.ncbi.nlm.nih.gov/pmc/articles/13656825"},"language":"en","primary_location":{"id":"doi:10.12659/ajcr.953196","doi":"https://doi.org/10.12659/ajcr.953196","is_oa":true,"landing_page_url":"https://doi.org/10.12659/ajcr.953196","pdf_url":"https://amjcaserep.com/download/inPress/idArt/953196","source":{"id":"https://openalex.org/S2756455307","display_name":"American Journal of Case Reports","issn_l":"1941-5923","issn":["1941-5923"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","dongbi-d","medline","poland-70","russia-white-list-2","vabb-shw"],"host_organization":"https://openalex.org/P4310320062","host_organization_name":"International Scientific Information Inc.","host_organization_lineage":["https://openalex.org/P4310320062"],"host_organization_lineage_names":["International Scientific Information Inc."],"type":"journal"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"American Journal of Case Reports","raw_type":"journal-article"},"volume":null,"type":"article","is_traditional":true,"indexed_in":["crossref","pubmed"],"open_access":{"is_oa":true,"oa_status":"hybrid","oa_url":"https://amjcaserep.com/download/inPress/idArt/953196","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5053516328","display_name":"Andris Vikmanis","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210097420","display_name":"Riga East University Hospital","ror":"https://ror.org/00ss42h10","country_code":"LV","type":"healthcare","lineage":["https://openalex.org/I4210097420"]}],"countries":["LV"],"is_corresponding":false,"raw_author_name":"Andris Vikmanis","raw_affiliation_strings":["Riga East Clinical University Hospital, Riga, Latvia"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Riga East Clinical University Hospital, Riga, Latvia","institution_ids":["https://openalex.org/I4210097420"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5148266350","display_name":"Olegs Ribakovs","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210097420","display_name":"Riga East University Hospital","ror":"https://ror.org/00ss42h10","country_code":"LV","type":"healthcare","lineage":["https://openalex.org/I4210097420"]}],"countries":["LV"],"is_corresponding":true,"raw_author_name":"Olegs Ribakovs","raw_affiliation_strings":["Riga East Clinical University Hospital, Riga, Latvia"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Riga East Clinical University Hospital, Riga, Latvia","institution_ids":["https://openalex.org/I4210097420"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5148390472","display_name":"Anete Labalaika","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210126294","display_name":"Riga Stradi\u0146\u0161 University","ror":"https://ror.org/03nadks56","country_code":"LV","type":"education","lineage":["https://openalex.org/I4210126294"]}],"countries":["LV"],"is_corresponding":false,"raw_author_name":"Anete Labalaika","raw_affiliation_strings":["Riga Stradins University, Riga, Latvia"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Riga Stradins University, Riga, Latvia","institution_ids":["https://openalex.org/I4210126294"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":2,"corresponding_author_ids":["https://openalex.org/A5148266350"],"corresponding_institution_ids":["https://openalex.org/I4210097420"],"apc_list":null,"apc_paid":null,"fwci":0.0,"has_fulltext":true,"cited_by_count":0,"citation_normalized_percentile":{"value":0.58871042,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":"27","issue":null,"first_page":"e953196","last_page":"e953196"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10658","display_name":"Bone fractures and treatments","score":0.7559000253677368,"subfield":{"id":"https://openalex.org/subfields/2732","display_name":"Orthopedics and Sports Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10658","display_name":"Bone fractures and treatments","score":0.7559000253677368,"subfield":{"id":"https://openalex.org/subfields/2732","display_name":"Orthopedics and Sports Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11293","display_name":"Orthopedic Infections and Treatments","score":0.23729999363422394,"subfield":{"id":"https://openalex.org/subfields/2746","display_name":"Surgery"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10512","display_name":"Orthopaedic implants and arthroplasty","score":0.0005000000237487257,"subfield":{"id":"https://openalex.org/subfields/2746","display_name":"Surgery"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/femoral-fracture","display_name":"femoral fracture","score":0.9639999866485596},{"id":"https://openalex.org/keywords/multidrug-resistant-infections","display_name":"multidrug-resistant infections","score":0.9120000004768372},{"id":"https://openalex.org/keywords/bone-defect-reconstruction","display_name":"bone defect repair","score":0.8880000114440918},{"id":"https://openalex.org/keywords/revision-hip-arthroplasty","display_name":"revision hip arthroplasty","score":0.7990000247955322},{"id":"https://openalex.org/keywords/cementless-femoral-stem","display_name":"cementless femoral stem","score":0.9010000228881836},{"id":"https://openalex.org/keywords/antimicrobial-therapy","display_name":"antimicrobial therapy","score":0.6819999814033508},{"id":"https://openalex.org/keywords/military-trauma","display_name":"military trauma","score":0.6880000233650208},{"id":"https://openalex.org/keywords/high-energy-trauma","display_name":"high-energy trauma","score":0.5920000076293945},{"id":"https://openalex.org/keywords/post-traumatic-osteoarthritis","display_name":"post-traumatic osteoarthritis","score":0.8299999833106995},{"id":"https://openalex.org/keywords/external-fixation","display_name":"external fixation","score":0.6039999723434448},{"id":"https://openalex.org/keywords/debridement","display_name":"debridement","score":0.7229999899864197}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.9789000153541565},{"id":"https://openalex.org/C29694066","wikidata":"https://www.wikidata.org/wiki/Q118301","display_name":"Orthodontics","level":1,"score":0.4050000011920929},{"id":"https://openalex.org/C141071460","wikidata":"https://www.wikidata.org/wiki/Q40821","display_name":"Surgery","level":1,"score":0.4025000035762787},{"id":"https://openalex.org/C43369102","wikidata":"https://www.wikidata.org/wiki/Q2307625","display_name":"Fracture (geology)","level":2,"score":0.3808000087738037},{"id":"https://openalex.org/C544519230","wikidata":"https://www.wikidata.org/wiki/Q32566","display_name":"Computed tomography","level":2,"score":0.30559998750686646},{"id":"https://openalex.org/C2780012534","wikidata":"https://www.wikidata.org/wiki/Q4350503","display_name":"Femoral fracture","level":3,"score":0.2996000051498413},{"id":"https://openalex.org/C2777560053","wikidata":"https://www.wikidata.org/wiki/Q503629","display_name":"Avascular necrosis","level":3,"score":0.28200000524520874},{"id":"https://openalex.org/C2780554211","wikidata":"https://www.wikidata.org/wiki/Q176503","display_name":"Femur","level":2,"score":0.27649998664855957},{"id":"https://openalex.org/C2775854910","wikidata":"https://www.wikidata.org/wiki/Q4844892","display_name":"Femoral neck","level":3,"score":0.26739999651908875},{"id":"https://openalex.org/C2779473830","wikidata":"https://www.wikidata.org/wiki/Q1540899","display_name":"MEDLINE","level":2,"score":0.2662999927997589},{"id":"https://openalex.org/C68312169","wikidata":"https://www.wikidata.org/wiki/Q216685","display_name":"Orthopedic surgery","level":2,"score":0.25529998540878296}],"mesh":[{"descriptor_ui":"D000328","descriptor_name":"Adult","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D000900","descriptor_name":"Anti-Bacterial Agents","qualifier_ui":"Q000627","qualifier_name":"therapeutic use","is_major_topic":false},{"descriptor_ui":"D003646","descriptor_name":"Debridement","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D005264","descriptor_name":"Femoral Fractures","qualifier_ui":"Q000601","qualifier_name":"surgery","is_major_topic":true},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D008297","descriptor_name":"Male","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D008889","descriptor_name":"Military Personnel","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D019644","descriptor_name":"Arthroplasty, Replacement, Hip","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D024901","descriptor_name":"Drug Resistance, Multiple, Bacterial","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false}],"locations_count":3,"locations":[{"id":"doi:10.12659/ajcr.953196","doi":"https://doi.org/10.12659/ajcr.953196","is_oa":true,"landing_page_url":"https://doi.org/10.12659/ajcr.953196","pdf_url":"https://amjcaserep.com/download/inPress/idArt/953196","source":{"id":"https://openalex.org/S2756455307","display_name":"American Journal of Case Reports","issn_l":"1941-5923","issn":["1941-5923"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","dongbi-d","medline","poland-70","russia-white-list-2","vabb-shw"],"host_organization":"https://openalex.org/P4310320062","host_organization_name":"International Scientific Information Inc.","host_organization_lineage":["https://openalex.org/P4310320062"],"host_organization_lineage_names":["International Scientific Information Inc."],"type":"journal"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"American Journal of Case Reports","raw_type":"journal-article"},{"id":"pmh:oai:pubmedcentral.nih.gov:13656825","doi":null,"is_oa":true,"landing_page_url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13656825/","pdf_url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13656825/pdf/amjcaserep-27-e953196.pdf","source":{"id":"https://openalex.org/S2764455111","display_name":"PubMed Central","issn_l":null,"issn":null,"is_oa":true,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Am J Case Rep","raw_type":"Text"},{"id":"pmid:42837321","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/42837321","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"The American journal of case reports","raw_type":"Journal Article"}],"best_oa_location":{"id":"doi:10.12659/ajcr.953196","doi":"https://doi.org/10.12659/ajcr.953196","is_oa":true,"landing_page_url":"https://doi.org/10.12659/ajcr.953196","pdf_url":"https://amjcaserep.com/download/inPress/idArt/953196","source":{"id":"https://openalex.org/S2756455307","display_name":"American Journal of Case Reports","issn_l":"1941-5923","issn":["1941-5923"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","dongbi-d","medline","poland-70","russia-white-list-2","vabb-shw"],"host_organization":"https://openalex.org/P4310320062","host_organization_name":"International Scientific Information Inc.","host_organization_lineage":["https://openalex.org/P4310320062"],"host_organization_lineage_names":["International Scientific Information Inc."],"type":"journal"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"American Journal of Case Reports","raw_type":"journal-article"},"sustainable_development_goals":[{"id":"https://metadata.un.org/sdg/3","score":0.9940000176429749,"display_name":"Good health and well-being"}],"study_designs":[{"id":"https://openalex.org/study-designs/case-report","display_name":"Case Report"}],"awards":[],"funders":[],"has_content":{"grobid_xml":true,"pdf":true},"content_urls":{"pdf":"https://content.openalex.org/works/W7204252199.pdf","grobid_xml":"https://content.openalex.org/works/W7204252199.grobid-xml"},"referenced_works_count":0,"referenced_works":[],"related_works":["https://openalex.org/W7158428410","https://openalex.org/W4405809383","https://openalex.org/W1112422132","https://openalex.org/W3028985376","https://openalex.org/W4288771561","https://openalex.org/W2734703302","https://openalex.org/W3159758996","https://openalex.org/W4386940267","https://openalex.org/W2179812369","https://openalex.org/W3207112489"],"abstract_inverted_index":{"BACKGROUND":[0],"The":[1],"Masquelet":[2,64,156,208],"induced":[3,65,157,209],"membrane":[4,29,66,158,210],"technique":[5],"is":[6],"a":[7,19,25,45,50,58,115,148,192,227,235],"2-stage":[8],"surgical":[9],"procedure":[10],"used":[11],"to":[12,23,104,118,161],"reconstruct":[13],"large":[14],"bone":[15,32,59,171],"defects":[16],"and":[17,57,86,132,151,169,175,216],"uses":[18],"temporary":[20],"cement":[21],"spacer":[22],"generate":[24],"biologically":[26],"active,":[27],"vascularized":[28],"that":[30,202],"promotes":[31],"healing":[33],"when":[34],"filled":[35],"with":[36,49,62,129,237],"an":[37,93,125],"autograft.":[38],"This":[39,199],"report":[40],"describes":[41],"the":[42,63,71,90,100,136,155,164,180,207],"case":[43,200],"of":[44,83,92,147,163],"37-year-old":[46],"military":[47],"man":[48],"high-energy":[51,238],"femoral":[52,194,239],"fracture,":[53],"multiple":[54,143],"debridement":[55,144],"procedures,":[56,145],"defect":[60,152],"managed":[61],"technique.":[67,159],"CASE":[68],"REPORT":[69],"In":[70,108],"patient's":[72],"home":[73],"country,":[74],"life-saving":[75],"surgery":[76],"was":[77,102,112,196],"performed,":[78],"followed":[79],"by":[80,221,242],"repeated":[81],"excision":[82],"damaged":[84],"tissue":[85],"long-term":[87],"treatment,":[88,140],"including":[89],"use":[91],"external":[94],"fixation":[95,178],"device.":[96],"After":[97],"6":[98],"months,":[99],"patient":[101,236],"transferred":[103],"Latvia":[105],"for":[106],"rehabilitation.":[107],"March":[109],"2023,":[110],"he":[111,141],"admitted":[113],"from":[114,135],"rehabilitation":[116],"center":[117],"Riga":[119],"East":[120],"Clinical":[121],"University":[122],"Hospital":[123],"in":[124,179,234],"acute":[126],"setting,":[127],"presenting":[128],"severe":[130],"pain":[131],"purulent":[133],"discharge":[134],"left":[137,188],"thigh.":[138],"During":[139],"underwent":[142],"insertion":[146],"cement-coated":[149],"nail,":[150],"reconstruction":[153],"using":[154,191],"Due":[160],"shortening":[162],"affected":[165],"limb,":[166],"post-traumatic":[167],"osteoarthritis,":[168],"poor":[170],"quality,":[172],"further":[173],"osteosynthesis":[174],"stable":[176],"implant":[177],"proximal":[181],"femur":[182],"were":[183],"not":[184],"feasible.":[185],"Consequently,":[186],"cementless":[187,212],"hip":[189,214],"arthroplasty":[190],"revision":[193,213],"stem":[195],"performed.":[197],"CONCLUSIONS":[198],"demonstrates":[201],"staged":[203],"orthopedic":[204],"management":[205],"combining":[206],"technique,":[211],"arthroplasty,":[215],"individualized":[217],"antimicrobial":[218],"therapy":[219],"guided":[220],"infectious":[222],"disease":[223],"consultation":[224],"can":[225],"achieve":[226],"favorable":[228],"functional":[229],"outcome":[230],"at":[231],"2-year":[232],"follow-up":[233],"trauma":[240],"complicated":[241],"multidrug-resistant":[243],"infection.":[244]},"counts_by_year":[],"updated_date":"2026-11-08T12:12:28.789561","created_date":"2026-08-27T00:00:00"}