Venunathan Gopinath, Tewari Abhinav, Thakur Kamparsh
Department of Orthopaedics, Military Hospital Roorkee, Roorkee, Uttarakhand, India.
Department of Anaesthesiology, Military Hospital Roorkee, Roorkee, Uttarakhand, India.
J Orthop Case Rep. 2023 Jul;13(7):56-59. doi: 10.13107/jocr.2023.v13.i07.3752.
Tibial tuberosity avulsion fractures in adolescents are one of the rare physeal injuries. Sudden powerful contraction of quadriceps muscle leads to avulsion fractures and varying degrees of disruption of extensor mechanism.
A 16-year-old boy sustained tibial tuberosity avulsion fracture while playing football and presented with sudden onset of pain, massive swelling, and loss of active extension of the left knee along with inability to bear weight on the left leg. Due to imminent risk of development of compartment, patient was taken for surgical correction immediately. Open reduction and internal fixation were done using 02 × 4 mm partially threaded cannulated cancellous screws. Patient was immobilized with above knee cast and kept non-weight bearing for 6 weeks. Later, gradual weight bearing ambulation was allowed and ROM and strengthening of knee was carried out. Patient had regained complete ROM of knee and returned to sporting activities by end of 6 months.
Tibial tuberosity avulsion fractures are a rare occurrence and even rarer is them getting complicated by compartment syndrome. A high index of suspicion for development of compartment syndrome in an avulsion fracture of tibial tuberosity and a timely management can avert such potential complications and enables to achieve an optimal results.
青少年胫骨结节撕脱骨折是罕见的骨骺损伤之一。股四头肌突然强力收缩导致撕脱骨折及伸膝装置不同程度的破坏。
一名16岁男孩在踢足球时发生胫骨结节撕脱骨折，表现为突发疼痛、严重肿胀、左膝主动伸直丧失以及无法负重行走。由于存在即将发生骨筋膜室综合征的风险，患者立即接受手术矫正。采用2枚4毫米部分螺纹空心松质骨螺钉进行切开复位内固定。患者用长腿石膏固定，6周内不负重。之后，逐渐允许负重行走，并进行膝关节活动度和力量训练。患者在6个月末恢复了膝关节的完全活动度，并重返体育活动。
胫骨结节撕脱骨折很少见，并发骨筋膜室综合征则更为罕见。对胫骨结节撕脱骨折发生骨筋膜室综合征保持高度怀疑并及时处理，可避免此类潜在并发症，并实现最佳治疗效果。
