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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

Four weeks after the accident: the MRI shows an intact posterior cruciate ligament (hypodense).
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Figure 7: Four weeks after the accident: the MRI shows an intact posterior cruciate ligament (hypodense).

Mentions: At the next outpatient visit four weeks later, a thorough physical examination of the right leg revealed an atrophic quadriceps muscle and a positive anterior drawer in comparison to the left side. Retrospective review of the previous MRI-films by an experienced colleague clearly depicted a previously missed rupture of the anterior cruciate ligament (ACL) with an enhanced signal of the tibial remainders of the ligament (Figure 7 and 8). Additionally, a pathologic signal along the tibial physeal plate was suspicious for the beginnings of a bony bridge. Upon questioning, the patient admitted that he had never been able to walk without pain on the injured leg since the cast was removed. As a result he had avoided regular activities and sports. Physical rehabilitation to compensate the joint instability by muscular means was initiated.


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)

Four weeks after the accident: the MRI shows an intact posterior cruciate ligament (hypodense).
© Copyright Policy
Related In: Results  -  Collection

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

Figure 7: Four weeks after the accident: the MRI shows an intact posterior cruciate ligament (hypodense).
Mentions: At the next outpatient visit four weeks later, a thorough physical examination of the right leg revealed an atrophic quadriceps muscle and a positive anterior drawer in comparison to the left side. Retrospective review of the previous MRI-films by an experienced colleague clearly depicted a previously missed rupture of the anterior cruciate ligament (ACL) with an enhanced signal of the tibial remainders of the ligament (Figure 7 and 8). Additionally, a pathologic signal along the tibial physeal plate was suspicious for the beginnings of a bony bridge. Upon questioning, the patient admitted that he had never been able to walk without pain on the injured leg since the cast was removed. As a result he had avoided regular activities and sports. Physical rehabilitation to compensate the joint instability by muscular means was initiated.

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