Fracture of the proximal tibial epiphysis with anterior displacement of the shaft: a case report

180

Injury,

4, 180-181

Fracture of the proximal tibia1 epiphysis with anterior displacement of the shaft: a case report H. I. Al-Kudairi Orthopaedic

Department,

Heatherwood

Summary

A case of fracture separation of the proximal epiphysis of the tibia is reported and illustrates the speed with which remodelling can occur. AS a g-year-old boy was crossing the street he was struck from behind by a car. Manipulation of the displaced upper end of the right tibia (Fig. 1) was delayed for 3 days because of concussion and, having regard to the different views, it made no obvious difference to the position of the fracture (Fig. 2). The limb was encased in plaster for 7 weeks. Figs. 3 and4 show the speed and completeness of remodelling. The lack of disturbance of growth up to 4 months after the injury can perhaps be ascribed to what was quite likely a shearing force with little or no crushing.

Hospital, Ascot

BIBLIOGRAPHY AITKEN,A. P., and INGERSOLL, R. E. (1956), ‘ Fractures of proximal tibia1 epiphysis ‘, J. Bone Jr Surg., 38A, 187. BBHLER, J. (1951), ‘ Zur behandlung der traumatischen epiphysenlosung am oberen scheinbeinende ‘, Chirurg, 22, 81. HUTCHINSON,J. (1894), ’ Lectures on injury to epiphysis and their results ‘, Br. med. J., 1,673. THEODOROU,S., MICHAIL, J., and PAPADOPOULOS,E. (1964), ‘ Post-traumatic epiphyseal detachment of the upper tibia1 epiphysis. Report on 3 cases ‘, Acta orthop. be/g., 30, 452. WELCH, P. H., and WYNNE, G. F., jun. (1963), ‘ Proximal tibia1 epiphyseal fracture separationcase report ‘, J. Bone Jt Slug., 45A, 782.

Acknowledgement I should like to thank Mr. R. H. Maudsley, F.R.C.S., for allowing me to present this case, which has been under his care.

Fig. 1.-Radiographs

on admission.

Fig. 2.-Position

after manipulation.

: Fracture

Al-Kudairi

of Proximal

Fig. 3.-Radiographs

Fig. 4.-Four

complete closure. Requests

for

months remodelling

reprints

should

181

Tibia1 Epiphysis

2 months after InJury.

after injury, there is almost and no sign of epiphyseal

be addressed

to:-H.

Fig. 5.-A diagram depicting the forces acting on the epiphysis at the moment of injury.

I. AI-Kudairi, Esq., F.R.C.S. (Edin.), Bugda University, Iraq.