جستجوی مقالات مرتبط با کلیدواژه « avulsion fracture » در نشریات گروه « پزشکی »

Only 3% of all proximal tibial fractures result in an avulsion fracture of the tibial tuberosity. It is often seen in youngsters between the ages of 3 and 6 and is less frequent after puberty.

Case Report:

A 15-year-old boy was presented with severe left knee pain following a high jump. X-ray and computed tomography (CT) scan showed a tibial tuberosity fracture with joint surface involvement. The damaged part was fixed with a 4.5mm cannulated screw and washer, reinforced with 2 SwiveLock anchors. In the sixth week, full weight bearing and full range of motion (ROM) were obtained.

The primary objective in managing tibial tubercle fractures is the restoration of both the extensor mechanism and the integrity of the joint surface in cases where they have been compromised.

We present a unique case of a 59-year-old shipyard worker who sustained an avulsion fracture of the tibialis anterior tendon, concurrently with a comminuted fracture at the base of the first metatarsal. This is the first reported case highlighting this concomitant presentation, which underlines the possibility of avulsion fractures accompanying comminuted fractures. Importantly, such avulsion fractures could lead to skin tenting and potential necrosis, necessitating early identification and prompt intervent ion. The patient underwent successful surgical intervention and displayed good functional restoration 15 months postoperatively. Level of evidence: IV

The posterior cruciate ligament (PCL) presents commonly as avulsion fractures from the tibial attachment site. Isolated tears of the PCLcan be caused by a fall on the flexed knee or dashboard injury in road traffic accident. Such a mechanism (the upper tibia driven posteriorly with the knee flexed) may produce PCL disruption as the only clinically detectable instability. For the PCL avulsion fractures fixation, there are various methods available like closed reduction and internal fixation (CRIF), open reduction and internal fixation (ORIF), and arthroscopic fixation. This study was performed to assess the result of PCL avulsionfracture managed with ORIF with cannulated cancellous screw.

We performed ORIF using cannulated cancellous screws with the posterior approach in 11 patients with isolated PCL tibial avulsion injuries. The minimum follow-up period was 6 months. The results were assessed radiologically and clinically. The spectrum of outcomes following PCL tibial avulsion fracture were measureusing the Lysholm knee scoring system and range of motion (ROM) of the knee joint.

63.6, 27.3, and 9.1percentof the cases had excellent, good,and moderate fracture healing, respectively.

PCL tibial avulsion fractures managed with open reduction with cannulated cancellous screw fixation yields good functional outcome with less complications.

Avulsion of tibial tuberosity is very rare injuries seen in adolescent boys. We hereby report a case of a 16‑year‑old obese boy with acute tibial tuberosity avulsion. The patient was obese weighing 110 kg. Fixation and rehabilitation was a challenge and hence we want publish this rare combination. To best of our knowledge, no such cases are reported. A 16‑year‑old boy presented to emergency department with a history of tripping from stairs. Clinicoradiological examination revealed closed acute tibial tuberosity avulsion. The patient was obese weighing 110 kg. The patient underwent fixation with cancellous screws and 5.5 mm suture anchor. Following a comprehensive rehabilitation, the patient regained complete range of motion and back to routine activities. Acute tibial tuberosity injuries are very rare injuries commonly seen in adolescent age. Associated injuries and comorbidities make the optimal treatment of such injuries challenging

The optimal surgical treatment of isolated tibial avulsion fractures of the Posterior Cruciate Ligament remains controversial. The purpose of this study was to evaluate the results of an arthroscopic technique using two ordinary portals and an incision to stabilize an avulsed fragment. Five patients were treated and followed up for 4 years. The mean score measured by KT-2000 was 9.2 mm preoperatively, 4.6 mm a year (P<0.042) and 3.8 mm 4 years postoperatively (p<0.041). This study showed that fixing the PCL avulsion fractures by a cannulated screw could improve knee function and stability.

The lateral epicondyle fracture in children is a rare condition and only few cases have been reported in the literature. The isolated fracture without concomitant fracture/dislocation is even more uncommon, with unclear outcome and treatment approach.

Case Report: 

We present a case of an 11-year-old boy with restricted right elbow range of motion (ROM) after falling. The radiograph and computed tomography (CT) scan showed a displaced lateral epicondyle fracture without accompanying fracture or dislocation. Due to the stability of the joint and patient’s compliance, a closed reduction with Kirschner wires (K-wires) was selected for treatment. Follow-up results were satisfactory and showed no complications.

Closed reduction of dislocated lateral epicondyle fracture in children can result in acceptable outcomes.

Several operative techniques have been described for operative treatment of posterior cruciate ligament (PCL) avulsion injuries. Here we introduce a new arthroscopic suture technique for the treatment of PCL avulsion fracture using Scorpion suture passer. Three standard portals of anteromedial, anterolateral, and posteromedial are established along with the central trans-patellar tendon portal, if necessary. A Scorpion suture passer and No. 2 FiberWire were used to put two sutures at the base of the PCL-bone interface. After reducing the fragment, a tibial target guide for PCL was used to make a tunnel at the center of the fracture site and the fragment, if possible. An Endotack is used to fix the sutures at the anterior border of the tibia. This is a practical technique with a short learning curve and biomechanically stable fixation.

There are controversial disputes regarding the ethical concerns for arthroscopic posterior cruciate ligament (PCL) avulsion fixation accompanied by various complications and difficulties. Firstly, this procedure maintains long learning curve, and it is still in a cast of dilemma if this procedure is justified, when a surgeon should undergo a considerable time and efforts in order to acquire enough experience regarding this novel procedure. Secondly, when stable fixation is not achieved, one may need to shift to open surgery; the issue arises when surgeon terminates the surgery just with somewhat fixation because he does not want to demonstrate any sign of weakness regarding his surgical skills. And finally, there are specific considerations that should be taken into account in the informed consent for an innovative surgery. Here the study discusses these terms in the faiths of fashioning a catalyst for further discussions.

Avulsion of extensor carpi radialis brevis (ECRB) insertion from dorsal base of the third metacarpal with or without bony chips is rarely reported.
The current study reported the case of a young male that after falling down the stairs, referred to emergency room with dorsal wrist pain and weakness in wrist extension, and the lateral X-ray showed a bone fragment of dorsal capitate, but the computed tomography (CT) scan proved that the fragment was detached from the third metacarpal base. Then, with the diagnosis of ECRB avulsion fracture of its metacarpal base, the patient was operated and the fragment and accompanying tendon were fixed with 3 k-wires to its anatomic location and after 6 weeks of casting the pins were removed and at 6 months post-operation the range of motion and strength were the same as those of contralateral side.
ECRB avulsion is a rare condition, and its diagnosis can be difficult, and it should be in differential diagnosis of wrist trauma with tenderness on the base of the third metacarpal bone.