Journal of pediatric orthopedics
-
Avulsion fracture of the tibial tubercle is an uncommon but severe injury of the proximal tibial physis in adolescents. These fractures are all Salter Type III injuries. The fracture line may extend through the proximal tibial articular surface. ⋯ Five of eight injuries were treated with open reduction and internal fixation. When the proximal tibial articular surface was involved in the fracture, anatomic reduction was the primary goal. This review demonstrates that this particular epiphyseal plate injury in the adolescent knee heals well without deformity or functional loss once adequate reduction and fixation of the fracture fragments have been achieved.
-
Case Reports Comparative Study
Computed tomography of intraarticular supination - eversion fractures of the ankle in adolescents.
Intraarticular fractures of the ankle in children known as the Tillaux and triplane fractures of the distal tibia are caused by supination-eversion. In order to determine the three-dimensional configuration of these fractures and the relation of the fracture to the growth plate and the joint, computed tomography (CT) was performed in one case with Tillaux fracture and in four cases with triplane fracture, besides conventional radiography and tomography. The Tillaux fracture showed two fragments. ⋯ In one case with a three fragment diagnosed by conventional tomography and CT, a four fragment fracture was revealed at operation. This patient had, in addition, a fracture through the anteromedial part of the growth plate without displacement. According to this and previous investigations, the Tillaux and triplane fractures represent at least five different anatomical pattern of intraarticular supination-eversion injuries.
-
A series of 40 young patients with lumbar spondylolisthesis is presented. The patients were treated surgically using osteoperiosteal transplants as the fusion material. In 29 patients, the fusion was posterior and in 11 patients posterolateral. ⋯ The best results were obtained using posterior fusion, while the rate of nonunion was higher in the posterolateral group. The periosteum was taken from the anteromedial aspect of the tibia using a sharp chisel. The method gives clinical and radiological results comparable with those obtained using bone transplants.