{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T10:54:03Z","timestamp":1789124043962,"version":"build-2803163510"},"reference-count":16,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec>\n                    <jats:title>Cases:<\/jats:title>\n                    <jats:p>Long-bone fractures in patients with Klippel-Tr\u00e9naunay syndrome (KTS), a rare disorder of the venous, lymphatic, and capillary system, are difficult to treat with many complications. Two patients diagnosed with KTS presented with closed femoral shaft fractures after low-energy falls. Conservative treatment, open reduction internal fixation, and intramedullary nailing resulted in painful nonunions. Ultimately, both patients achieved pain relief and the ability to ambulate after en bloc resection and reconstruction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>These cases demonstrate the challenges in achieving bony union when treating long-bone fractures in KTS. The feasibility of undergoing extensive resection and reconstruction to regain function is best approached with a multidisciplinary team.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.cc.21.00136","type":"journal-article","created":{"date-parts":[[2021,8,16]],"date-time":"2021-08-16T15:01:16Z","timestamp":1629126076000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":3,"title":["Treatment of Femoral Shaft Fractures in Patients with Klippel-Tr\u00e9naunay Syndrome"],"prefix":"10.2106","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2078-1150","authenticated-orcid":false,"given":"Adel","family":"Mahjoub","sequence":"first","affiliation":[{"name":"Cooper Bone and Joint Institute, Camden, New Jersey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5074-4927","authenticated-orcid":false,"given":"Grace","family":"Gilbert","sequence":"additional","affiliation":[{"name":"Cooper Bone and Joint Institute, Camden, New Jersey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0281-8581","authenticated-orcid":false,"given":"Stefan","family":"Turkula","sequence":"additional","affiliation":[{"name":"Cooper Bone and Joint Institute, Camden, New Jersey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory","family":"Mendez","sequence":"additional","affiliation":[{"name":"Cooper Bone and Joint Institute, Camden, New Jersey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5491-1094","authenticated-orcid":false,"given":"Kenneth","family":"Graf","sequence":"additional","affiliation":[{"name":"Cooper Bone and Joint Institute, Camden, New Jersey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1533-0032","authenticated-orcid":false,"given":"Tae Won B.","family":"Kim","sequence":"additional","affiliation":[{"name":"Cooper Bone and Joint Institute, Camden, New Jersey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2021,7]]},"reference":[{"key":"bib1-20240805","first-page":"641","article-title":"Du noevus variqueux osteo-hypertrophique","volume":"185","author":"Klippel","year":"1900","journal-title":"Arch Gen Med Paris."},{"issue":"5","key":"bib2-20240805","first-page":"e8023","article-title":"Presentation and management of Klippel-Trenaunay syndrome: a review of available data","volume":"12","author":"Asghar","year":"2020","journal-title":"Cureus."},{"key":"bib3-20240805","first-page":"231","article-title":"Angioma formation in connection with hypertrophy of limbs and hemihypertrophy","volume":"19","author":"Parkes-Weber","year":"1907","journal-title":"Br J Dermatol Syph."},{"issue":"2","key":"bib4-20240805","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1097\/00000658-196508000-00023","article-title":"The Klippel Trenaunay syndrome: hypertrophy and hemangioma with no arteriovenous fistula","volume":"162","author":"Lindenauer","year":"1965","journal-title":"Ann Surg."},{"issue":"1","key":"bib5-20240805","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1111\/cge.12832","article-title":"CLOVES syndrome: review of a PIK3CA-related overgrowth spectrum (PROS)","volume":"91","author":"Martinez-Lopez","year":"2017","journal-title":"Clin Genet."},{"issue":"23","key":"bib6-20240805","first-page":"5094","article-title":"Haploinsufficiency of Klippel-Trenaunay syndrome gene Aggf1 inhibits developmental and pathological angiogenesis by inactivating PI3K and AKT and disrupts vascular integrity by activating VE-cadherin","volume":"25","author":"Zhang","year":"2016","journal-title":"Hum Mol Genet."},{"issue":"3","key":"bib7-20240805","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1055\/s-0035-1564440","article-title":"Overgrowth syndromes","volume":"4","author":"Edmondson","year":"2015","journal-title":"J Pediatr Genet."},{"issue":"4","key":"bib8-20240805","doi-asserted-by":"crossref","first-page":"1244","DOI":"10.1016\/j.juro.2006.11.099","article-title":"Klippel-Trenaunay syndrome: incidence and treatment of genitourinary sequelae","volume":"177","author":"Husmann","year":"2007","journal-title":"J Urol."},{"key":"bib9-20240805","first-page":"8505038","article-title":"Management of femoral shaft fracture in Klippel-Trenaunay syndrome with external fixator","volume":"2016","author":"Gupta","year":"2016","journal-title":"Case Rep Orthop."},{"key":"bib10-20240805","first-page":"548161","article-title":"A case of femoral fracture in Klippel Trenaunay syndrome","volume":"2014","author":"Nahas","year":"2014","journal-title":"Case Rep Orthop."},{"key":"bib11-20240805","doi-asserted-by":"crossref","first-page":"8852","DOI":"10.4076\/1757-1626-2-8852","article-title":"Management of a femoral diaphyseal fracture in a patient with Klippel-Trenaunay-Weber syndrome: a case report","volume":"2","author":"Tsaridis","year":"2009","journal-title":"Cases J."},{"key":"bib12-20240805","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1186\/s12891-020-03224-2","article-title":"Diagnosis of Klippel-Trenaunay syndrome and extensive heterotopic ossification in a patient with a femoral fracture: a case report and literature review","volume":"21","author":"Zhu","year":"2020","journal-title":"BMC Musculoskelet Disord."},{"issue":"7","key":"bib13-20240805","doi-asserted-by":"crossref","first-page":"993","DOI":"10.1007\/s00402-012-1504-9","article-title":"Klippel-Trenaunay syndrome: a rare cause of disabling pain after a femoral fracture","volume":"132","author":"Notarnicola","year":"2012","journal-title":"Arch Orthop Trauma Surg."},{"issue":"1","key":"bib14-20240805","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1213\/ANE.0b013e31821a03c2","article-title":"Anesthesia for surgery related to Klippel-Trenaunay syndrome: a review of 136 anesthetics","volume":"113","author":"Barbara","year":"2011","journal-title":"Anesth Analg."},{"issue":"12","key":"bib15-20240805","doi-asserted-by":"crossref","first-page":"e1527","DOI":"10.3928\/01477447-20131120-17","article-title":"Bloodless surgery by a regional intraarterial tourniquet during primary and revision THA","volume":"36","author":"Bernasek","year":"2013","journal-title":"Orthopedics."},{"issue":"1","key":"bib16-20240805","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1097\/00005373-197801000-00015","article-title":"Hemorrhage from open pelvic fracture controlled intraoperatively with balloon catheter","volume":"18","author":"Sheldon","year":"1978","journal-title":"J Trauma."}],"container-title":["JBJS Case Connector"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.2106\/JBJS.CC.21.00136","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T13:36:02Z","timestamp":1787751362000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.2106\/JBJS.CC.21.00136"}},"subtitle":["A Report of 2 Cases"],"short-title":[],"issued":{"date-parts":[[2021,7]]},"references-count":16,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2021]]}},"URL":"https:\/\/doi.org\/10.2106\/jbjs.cc.21.00136","relation":{},"ISSN":["2160-3251"],"issn-type":[{"value":"2160-3251","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,7]]}}}