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Ligamentous rupture of the ACL associated with dislocated fracture of the proximal tibial physis in a 12-year-old boy.

Scholz S, Köpke J, Wessel LM - BMC Musculoskelet Disord (2002)

Bottom Line: This unusual fracture classically excludes rupture of the anterior cruciate ligament due to the ligament's stability.A combination of both injuries has not been previously published in the literature.The authors report the case of a 12-year-old boy who presented with a dislocated fracture (Salter-Harris II) of the proximal tibia combined with ligamentous rupture of the anterior cruciate ligament after a sporting accident.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Surgery, Vanderbilt University Medical Center, Nashville/TN, USA. stefan.scholz@mcmail.vanderbilt.edu

ABSTRACT

Background: Dislocated fracture of the proximal physeal plate of the tibia with or without metaphyseal fragment is rare in children. This unusual fracture classically excludes rupture of the anterior cruciate ligament due to the ligament's stability. A combination of both injuries has not been previously published in the literature.

Case presentation: The authors report the case of a 12-year-old boy who presented with a dislocated fracture (Salter-Harris II) of the proximal tibia combined with ligamentous rupture of the anterior cruciate ligament after a sporting accident.

No MeSH data available.


Related in: MedlinePlus

Intraoperative fluoroscopy after reduction (anterior-posterior view).
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Figure 4: Intraoperative fluoroscopy after reduction (anterior-posterior view).

Mentions: A 12-year old corpulent boy presented to the emergency room of our clinic after trauma to the right knee. When asked about the mechanism of injury, he stated that two fellow players had fallen on his right leg at a handball game. His chief complaints were severe pain and tenderness around the proximal tibia. On examination, an effusion of the knee joint with substantial extraarticular swelling was noted. It was impossible to perform the appropriate function tests at the time of presentation secondary to swelling and pain at the joint. Therefore, no ligamentous injuries were detected on exam. Initial radiographs in three planes showed a slightly dislocated epiphysis of the proximal tibia with a metaphyseal fragment (Salter-Harris II), but no other osseous findings (Figures 1 and 2). The direction of the dislocation was anterior and lateral. Standard blood works was unremarkable. A hormonal disorder was not suspected because his history revealed a normal childhood development along the 97th percentile with overweight running in his family. Physical exam showed a genital development appropriate for his age. Subsequently, the boy was taken to the operating room to reduce the fracture under general anesthesia. Intraoperative films demonstrated restoration of accurate anatomic alignment of the bony fragments (Figures 3 and 4).


Ligamentous rupture of the ACL associated with dislocated fracture of the proximal tibial physis in a 12-year-old boy.

Scholz S, Köpke J, Wessel LM - BMC Musculoskelet Disord (2002)

Intraoperative fluoroscopy after reduction (anterior-posterior view).
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC78999&req=5

Figure 4: Intraoperative fluoroscopy after reduction (anterior-posterior view).
Mentions: A 12-year old corpulent boy presented to the emergency room of our clinic after trauma to the right knee. When asked about the mechanism of injury, he stated that two fellow players had fallen on his right leg at a handball game. His chief complaints were severe pain and tenderness around the proximal tibia. On examination, an effusion of the knee joint with substantial extraarticular swelling was noted. It was impossible to perform the appropriate function tests at the time of presentation secondary to swelling and pain at the joint. Therefore, no ligamentous injuries were detected on exam. Initial radiographs in three planes showed a slightly dislocated epiphysis of the proximal tibia with a metaphyseal fragment (Salter-Harris II), but no other osseous findings (Figures 1 and 2). The direction of the dislocation was anterior and lateral. Standard blood works was unremarkable. A hormonal disorder was not suspected because his history revealed a normal childhood development along the 97th percentile with overweight running in his family. Physical exam showed a genital development appropriate for his age. Subsequently, the boy was taken to the operating room to reduce the fracture under general anesthesia. Intraoperative films demonstrated restoration of accurate anatomic alignment of the bony fragments (Figures 3 and 4).

Bottom Line: This unusual fracture classically excludes rupture of the anterior cruciate ligament due to the ligament's stability.A combination of both injuries has not been previously published in the literature.The authors report the case of a 12-year-old boy who presented with a dislocated fracture (Salter-Harris II) of the proximal tibia combined with ligamentous rupture of the anterior cruciate ligament after a sporting accident.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Surgery, Vanderbilt University Medical Center, Nashville/TN, USA. stefan.scholz@mcmail.vanderbilt.edu

ABSTRACT

Background: Dislocated fracture of the proximal physeal plate of the tibia with or without metaphyseal fragment is rare in children. This unusual fracture classically excludes rupture of the anterior cruciate ligament due to the ligament's stability. A combination of both injuries has not been previously published in the literature.

Case presentation: The authors report the case of a 12-year-old boy who presented with a dislocated fracture (Salter-Harris II) of the proximal tibia combined with ligamentous rupture of the anterior cruciate ligament after a sporting accident.

No MeSH data available.


Related in: MedlinePlus