Fractures of the proximal tibial epiphysis.
ABSTRACT Fractures of the proximal tibial epiphysis are rare. A series of twenty-eight fractures classified according to the Salter-Harris method showed that nine were Type II and eight, Type IV. Lawn-mower injuries, a previously unreported mode of injury for this fracture, caused five of the eight Type-IV fractures and were associated with the worst prognosis by far. Two Type-V fractures in the proximal tibial epiphysis, previously unreported, are described.
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ABSTRACT: We report a very rare case of a 16-year-old healthy athletic boy who sustained simultaneous bilateral transitional fractures of the proximal tibia after kicking a football with his right leg during a soccer game. Following minimal invasive plate osteosynthesis with bridging of the growth plate, the patient recovered rapidly without any growth disturbances.Case reports in orthopedics. 01/2013; 2013:724802.
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ABSTRACT: INTRODUCTION: Both the isolated distal femoral epiphysiolysis and the isolated proximal tibial epiphysiolysis are the least common epiphyseal injuries. Even though they are uncommon, they have a high incidence rate of complications. CASE PRESENTATION: We present a case with Gustilo-Anderson grade 3b open and Salter-Harris type 1 epiphysiolysis of the distal femur and proximal tibia caused by a farm machinery accident. The patient was a 10-year-old boy, treated by open reduction and internal fixation. CONCLUSION: Although distal femoral and proximal tibial growth plate injuries are rarely seen benign fractures, their management requires meticulous care. Anatomic reduction is important, especially to minimize the risk of growth arrest and the development of degenerative arthritis. However, there is a high incidence of growth arrest and neurovascular injury with these type of fractures.Journal of Medical Case Reports 05/2013; 7(1):146.
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ABSTRACT: Proximal tibial physeal injuries are quite rare, but their complications can be of great importance. The purpose of this study was to evaluate the effect of this injury on the axis and length of a child's limb. This study focused on 12 patients with proximal physeal injury of the tibia (8 boys and 4 girls; mean age at the time of injury: 8.9 years). Injuries were classified according to the Salter-Harris scheme into 5 types (type II--7 patients, type III--3 patients, type IV--1 patient, type V--1 patient). In 5 cases, a coexisting fracture of the injured limb was observed (fibular fracture--3 cases, intercondylar fracture--1 case, tibial tubercle fracture--1 case). Ten patients were treated conservatively and 2 patients underwent an operation. Seven of the 12 patients were available for long-term follow-up, with a mean duration of 14.4 years (11.2-22.0 years). Angular deformity was observed in 6 of the 7 patients, with a mean valgus deformity of 2.7°, within an average of 5.8 months after the injury. After 3 years of follow-up, complete remodeling was observed in all of those 6 cases (4 of the patients were treated conservatively and 2 underwent surgery). One patient developed 6 mm of tibial shortening. No functional limitation or pain was recorded in any of the patients during the follow-up. Injury to the proximal tibial epiphysis, while rare, may result in angular or length disturbance, regardless of the initial treatment (conservative or surgical). Parents should always be informed of this possibility, and long follow-up is indicated. Nevertheless, this type of injury rarely results in functional limitations.Journal of Orthopaedics and Traumatology 03/2012; 13(1):7-11.