Direct Repair of Bilateral Inferior Articular Process Fractures in a Young Athlete Using the Buck Method: A Case
Ryohei Saito1, Shunsuke Fujibayashi2, Takashi Sono1
1Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Case:
A 16-year-old male baseball player had persistent low back pain for 5 months. Computed tomography revealed bilateral inferior articular process (IAP) fractures of L5 with large displaced fragments. Conservative treatment failed. Given the potential for instability from fragment removal and the possible impact on athletic performance from interbody fusion, the Buck technique was employed for direct repair. Postoperatively, bone fusion was achieved while maintaining lumbar mobility. He returned to competitive baseball and remained asymptomatic.
Conclusion:
For IAP fractures with large fragments, direct repair should be considered to preserve spinal stability and optimize function, especially in athletes requiring lumbar mobility.
