Beslikas Theodoros, Christodoulou Andreas, Chytas Anastasios, Gigis Ioannis, Christoforidis John
2nd Orthopaedic Department, General Hospital "G.Gennimatas", Aristotle University of Thessaloniki, 54635 Thessaloniki, Greece.
Case Rep Orthop. 2012;2012:219231. doi: 10.1155/2012/219231. Epub 2012 Aug 13.
Salter-Harris type V fracture is a very rare injury in the immature skeleton. In most cases, it remains undiagnosed and untreated. We report a case of genu recurvatum deformity in a 15-year-old boy caused by a Salter-Harris type V fracture of the proximal tibial physis. The initial X-ray did not reveal fracture. One year after injury, genu recurvatum deformity was detected associated with significant restriction of knee flexion and limp length discrepancy (2 cm) as well as medial and posterior instability of the joint. Further imaging studies revealed anterior bone bridge of the proximal tibial physis. The deformity was treated with a high tibial dome osteotomy combined with a tibial tubercle osteotomy stabilized with malleolar screws and a cast. Two years after surgery, the patient gained functional knee mobility without clinical instability. Firstly, this case highlights the importance of early identification of this rare lesion (Salter-Harris type V fracture) and, secondly, provides an alternative method of treatment for genu recurvatum deformity.
Salter-Harris V型骨折在未成熟骨骼中是一种非常罕见的损伤。在大多数情况下，它仍未被诊断和治疗。我们报告一例15岁男孩因胫骨近端骨骺Salter-Harris V型骨折导致膝反屈畸形的病例。最初的X线检查未发现骨折。受伤一年后，发现膝反屈畸形，伴有膝关节屈曲明显受限、跛行腿长差异（2厘米）以及关节内翻和后向不稳定。进一步的影像学研究显示胫骨近端骨骺前方骨桥形成。采用高位胫骨穹窿截骨术联合胫骨结节截骨术，并用踝螺钉和石膏固定治疗该畸形。术后两年，患者膝关节获得了功能性活动，无临床不稳定。首先，该病例突出了早期识别这种罕见损伤（Salter-Harris V型骨折）的重要性，其次，为膝反屈畸形提供了一种替代治疗方法。
