Newman Christopher, Musiienko Dharsh, Law Samuel
Western Health Department of Orthopaedics, Footscray Hospital, Gordon Street, Footscray, VIC 3011, Australia.
Case Rep Orthop. 2017;2017:5925421. doi: 10.1155/2017/5925421. Epub 2017 Apr 3.
Fractures of the proximal tibial epiphysis are rare, representing less than 3% of all epiphyseal and 1% of all physeal injuries in adolescents. Bilateral injuries are extremely rare. The specific anatomical and histological features of the proximal tibial epiphysis make it vulnerable to a specific fracture pattern that occurs when the tensile force of the quadriceps is greater than the fibrocartilaginous tissue underlying the tibial tuberosity. We report the first case to our knowledge of a 12-year-old boy who sustained simultaneous bilateral tibial avulsion fractures on the background of a previous conservatively managed unilateral tibial tuberosity avulsion fracture. We report this case for its uniqueness and as an educational review of the anatomy, the mechanism of injury, and the development of classifying these fractures and discussion of the stages of the growing physis that determine the treatment approach.
胫骨近端骨骺骨折较为罕见，在青少年所有骨骺损伤中占比不到3%，在所有骺板损伤中占比1%。双侧损伤极为罕见。胫骨近端骨骺独特的解剖和组织学特征使其易出现一种特定的骨折类型，这种骨折发生于股四头肌的张力大于胫骨结节下方纤维软骨组织之时。据我们所知，我们报告了首例病例，一名12岁男孩，在先前经保守治疗的单侧胫骨结节撕脱骨折的基础上，同时发生双侧胫骨撕脱骨折。我们报告该病例是因其独特性，也是作为对解剖结构、损伤机制、此类骨折分类的发展以及决定治疗方法的生长骺板各阶段的教学回顾。
