Kumar Prasoon, Agarwal Saurabh, Kumar Deepak, Rajnish Rajesh Kumar, Jindal Karan
Post Graduate Institute of Medical Education & Research, sector 12, Chandigarh 160012, India.
Trauma Case Rep. 2019 Feb 15;20:100174. doi: 10.1016/j.tcr.2019.100174. eCollection 2019 Apr.
Proximal tibia intra-articular fractures are commonly associated with ligamentous injuries and require early diagnosis and intervention. An array of fracture patterns can be encountered, and Schatzker's classification is a standard description to identify them. However, several patterns have been described that fall outside the ambits of this classification. We present a rare fracture pattern of partial posteromedial condyle coronal split associated with depression of the anterolateral plateau and mid substance tear of medial collateral ligament (MCL) and avulsions of anterior and posterior cruciate ligaments(ACL/PCL).
A 45 year old male presented with swelling and severe pain in his right knee after an accident. He was diagnosed with a posteromedial tibial condyle coronal split with two fragments, along with multi-ligament injuries. He was operated with cannulated screws and a rim plate for the larger fragment. The fractures united and patient was doing well in his daily activities at final follow up of 15 months.
Proximal tibia fractures can present as an array of fracture patterns and require prompt diagnosis and surgical management. The one described in the present case is a rarest of rare pattern and rim plating could be a cheaper alternative to the anatomical plates.
胫骨近端关节内骨折常伴有韧带损伤，需要早期诊断和干预。可能会遇到一系列骨折类型，Schatzker分类是识别这些骨折的标准描述。然而，有几种骨折类型超出了该分类的范围。我们报告一种罕见的骨折类型，即后内侧髁部分冠状面劈裂伴前外侧平台凹陷、内侧副韧带中部撕裂以及前后交叉韧带撕脱。
一名45岁男性在事故后出现右膝肿胀和剧痛。他被诊断为后内侧胫骨髁冠状面劈裂，有两块骨折碎片，同时伴有多韧带损伤。对较大的骨折碎片采用空心螺钉和边缘钢板进行手术治疗。骨折愈合，在15个月的最终随访中，患者日常活动情况良好。
胫骨近端骨折可表现为多种骨折类型，需要及时诊断和手术治疗。本病例中描述的骨折类型极为罕见，边缘钢板可能是解剖钢板更经济的替代方案。
