Dauwe Jan, Kerkhove Olivier Van, Unterfrauner Ines, Dauwe Dirk
Department of Trauma Surgery, University Hospitals Leuven, Leuven, Belgium.
Department of Medicine, Catholic University of Leuven, Leuven, Belgium.
J Orthop Case Rep. 2018 Sep-Oct;8(5):32-35. doi: 10.13107/jocr.2250-0685.1198.
Avulsion fractures of the tibial intercondylar eminence are rare and occur mostly in children. The purpose of this paper is to present a case of this rare pathology and to underline the importance of early diagnosis.
A male 8-year-old child presented with pain in his left knee and difficulties to walk after a combined injury of falling and contact trauma. Radiographic studies with conventional X-ray and computed tomography (CT) scan depicted a fracture of the intercondylar eminence. In this Type II fracture according to the classification of Meyers and McKeever, an operative treatment with knee arthroscopy was established to remove the loose bone. Post-operative, the knee was immobilized in extension for 4 weeks. Physiotherapy was initiated immediately after surgery. The follow-up CT scan 6weeks after injury showed a starting consolidation and the magnetic resonance imaging scan 8 weeks after injury a complete consolidation of the fracture.
Hyperflexion and rotation trauma result rather in bony avulsions than in ligamentous lesions in pediatric patients. Early diagnostic examination with conventional X-ray and CTscans is performed to not miss concomitant injuries. Depending on the type of eminentiaintercondylaris fracture, an operative or conservative treatment is indicated.
胫骨髁间隆起撕脱骨折较为罕见,多见于儿童。本文旨在报告一例这种罕见的病例,并强调早期诊断的重要性。
一名8岁男性儿童在摔倒和接触性创伤的复合伤后,出现左膝疼痛和行走困难。通过传统X线和计算机断层扫描(CT)进行的影像学检查显示髁间隆起骨折。根据迈尔斯和麦基弗的分类,该骨折为II型,遂采用膝关节镜手术治疗以清除游离骨块。术后,膝关节伸直固定4周。术后立即开始物理治疗。伤后6周的随访CT扫描显示骨折开始愈合,伤后8周的磁共振成像扫描显示骨折完全愈合。
在儿童患者中,过度屈曲和旋转创伤更易导致骨撕脱而非韧带损伤。应进行传统X线和CT扫描的早期诊断检查,以免漏诊合并伤。根据髁间隆起骨折的类型,可采取手术或保守治疗。