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Eur J Pediatr Surg 2009; 19(1): 41-43
DOI: 10.1055/s-2008-1038443
Case Report

© Georg Thieme Verlag KG Stuttgart · New York

Consecutive Bilateral Proximal Tibial Fractures after Minor Sports Trauma

R. Kraus1 , L. D. Berthold2 , C. Heiss1 , M. Läßig2
  • 1Department of Trauma Surgery, University Hospital Giessen, Giessen, Germany
  • 2Department of Pediatric Radiology, University Hospital Giessen, Giessen, Germany
Further Information

Publication History

received November 28, 2007

accepted after revision January 25, 2008

Publication Date:
15 July 2008 (online)

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Abstract

Introduction: Fractures of the proximal tibia are infrequent during childhood and adolescence. However, intra-articular fractures, growth plate separations and metaphyseal fractures do appear. Case Report: An obese adolescent male suffered from consecutive bilateral fractures of the tibia within 6 months of each after minor sports trauma. On the left side, the injury presented as a epiphyseal separation of the Salter-Harris I type; on the right side, as a transitional two-plane fracture. Both injuries were treated by percutanous screwing and healed without any signs of posttraumatic growth disorder. Discussion: Although proximal tibial injuries are rare, they frequently seem to appear bilaterally after inadequate trauma. A causal connection to morphological changes prior to physeal closure can be assumed.

Key words

epiphyseal separation - transitional fracture - proximal tibia - adolescence - minor trauma

References

  • 1 Barmada A, Gaynor T, Mubarak S J. Premature physeal closure following distal tibia physeal fractures: a new radiographic predictor.  J Pediatr Orthop. 2003;  23 733-739
    CrossrefPubMedSearch in Google Scholar
  • 2 Baxmann T. The fracture of proximal tibial epiphysis – a rare injury.  Akt Traumatol. 2006;  36 241-246
    Thieme ConnectPubMedSearch in Google Scholar
  • 3 Eastell J. Role of oestrogen in the regulation of bone turnover at the menarche.  J Endocrinol. 2005;  185 223-234
    CrossrefPubMedSearch in Google Scholar
  • 4 Eid A M, Hafez M A. Traumatic injuries of the distal femoral physis.  Injury. 2002;  33 251-255
    CrossrefPubMedSearch in Google Scholar
  • 5 Gautier F, Ziran B H, Egger B, Slongo T, Jakob R P. Growth disturbances after injuries of the proximal tibial epiphysis.  Arch Orthop Trauma Surg. 1998;  118 37-41
    PubMedSearch in Google Scholar
  • 6 Hasler C C, von Laer L. Pathogenesis of posttraumatic deformities of the lower extremities during growth.  Orthopäde. 2000;  9 757-765
    PubMedSearch in Google Scholar
  • 7 Jonasch E, Bertel E. Verletzungen bei Kindern bis zum 14. Lebensjahr.  H Unfallheilk. 1981;  150 1-146
    PubMedSearch in Google Scholar
  • 8 Kraus R, Ploss C, Staub L, Lieber J, Alt V, Weinberg A, Worel A, Schneidmüller D, Röder C. Fractures of long bones in children and adolescents.  Osteo Trauma Care. 2006;  14 39-44
    PubMedSearch in Google Scholar
  • 9 von Laer L, Kraus R, Linhart W. Frakturen und Luxationen im Wachstumsalter. 5. Auflage. Stuttgart; Georg Thieme Verlag 2007
    Search in Google Scholar
  • 10 Lalonde F, Wenger D. Tibia. Wenger D, Pring M Rang's Children's Fractures. 3rd ed. Philadelphia; Lippincott Williams & Wilkins 2005: 215-226
    Search in Google Scholar
  • 11 Özokay L, Michler K, Müsgens J. Bilateral atraumatic epiphysiolysis of the head of the tibia.  Unfallchirurg. 2002;  105 735-739
    CrossrefPubMedSearch in Google Scholar
  • 12 Rappold G, Vischer H M. Bilateral separation of the upper tibial epiphysis by somersault diving.  Unfallchirurgie. 1992;  18 229-232
    PubMedSearch in Google Scholar
  • 13 Rhembrev S J, Sleeboom C, Ekkelkamp S. Epiphyseal fractures of the proximal tibia.  Injury. 2000;  31 131-134
    CrossrefPubMedSearch in Google Scholar
  • 14 Rohmiller M T, Gaynor T P, Pawelek J, Mubarak S J. Salter-Harris I and II fractures of the distal tibia: does mechanism of injury relate to premature physeal closure?.  J Pediatr Orthop. 2006;  26 322-328
    CrossrefPubMedSearch in Google Scholar
  • 15 Rose S. Knie. von Laer L Das verletzte Kind. Stuttgart; Georg Thieme Verlag 2007: 82-89
    Search in Google Scholar
  • 16 Salter R B, Harris W R. Injuries involving the epiphyseal plate.  J Bone Joint Surg [Am]. 1963;  45 587-622
    PubMedSearch in Google Scholar
  • 17 Schneidmüller D, Marzi I. Knie. Marzi I Kindertraumatologie. Darmstadt; Steinkopff Verlag 2006: 301-315
    Search in Google Scholar
  • 18 Stephens D C, Louis E, Louis D S. Traumatic separation of the distal femoral epiphyseal cartilage plate.  J Bone Joint Surg [Am]. 1974;  56 1383-1390
    PubMedSearch in Google Scholar
  • 19 Trepte C T, Naumann T, Wetzel R. Epiphysiolysis of the proximal tibia – an atypical sports injury?.  Sportverletz Sportschaden. 1988;  2 172-177
    PubMedSearch in Google Scholar
  • 20 Waldegger M, Huber B, Kathrein A, Sitte I. Correction of the leg axis after epiphyseal fracture and progredient abnormal growth in the proximal tibia.  Unfallchirurg. 2001;  104 261-265
    CrossrefPubMedSearch in Google Scholar
  • 21 Weinberg A M, Kutschera C, Kutscha-Lissberg F, Mayr J. Proximaler metaphysärer Unterschenkel. Weinberg AM, Tscherne H Unfallchirurgie im Kindesalter. Berlin; Springer Verlag 2006: 743-750
    Search in Google Scholar
  • 22 Wilfinger C, Raith J, Pilhatsch A, Höllwarth M E, Weinberg A M. Tibial eminence fractures of children and adolescents – a retrospective study with MRI of the affected knee.  Akt Traumatol. 2005;  35 218-235
    Thieme ConnectPubMedSearch in Google Scholar
  • 23 Wozasek G E, Moser K D, Haller H, Capousek M. Trauma involving the proximal tibial epiphysis.  Arch Orthop Trauma Surg. 1991;  110 301-306
    PubMedSearch in Google Scholar

Dr. Ralf Kraus

Department of Trauma Surgery
University Hospital Giessen

Rudolf-Buchheim-Straße 7

35385 Giessen

Germany

Email: ralf.kraus@chiru.med.uni-giessen.de