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Proximal tibial epiphyseal fracture in an infant
Insights
This case report details the youngest infant diagnosed with a proximal tibial epiphyseal fracture, resulting from child abuse. Surgical intervention was necessary due to the fracture
Area of Science:
- Pediatric Orthopedics
- Traumatology
- Child Abuse Research
Background:
- Proximal tibial epiphyseal fractures are uncommon, typically affecting older children and adolescents.
- These fractures have not been previously documented in infants.
- Child abuse is a significant concern in pediatric trauma cases.
Observation:
- A 7-month-old female infant presented with a displaced Salter-Harris type II proximal tibial fracture.
- The injury was attributed to non-accidental trauma (child abuse).
- This is the youngest reported case of such a fracture.
Findings:
- Closed reduction failed to achieve anatomical alignment due to periosteal and pes anserinus infolding.
- Open reduction and internal fixation were required for successful fracture management.
- Postoperative tibia valga developed secondary to asymmetrical physeal overgrowth, necessitating corrective osteotomy.
Implications:
- This case expands the known age range for proximal tibial epiphyseal fractures.
- It highlights the importance of considering child abuse in infant fractures.
- Complex management and potential long-term complications like physeal overgrowth must be recognized.
Abstract:
Proximal tibial epiphyseal fractures are rare injuries occurring predominantly in older children and adolescents. They have not previously been reported in infants. The present case is that of a 7-month-old female infant with a displaced Salter-Harris type II fracture secondary to child abuse. This represents the youngest documented case of a proximal tibial epiphyseal fracture. Open reduction and internal fixation were performed because of failure to obtain an anatomic alignment by closed reduction. The anatomic reason for unsuccessful closed reduction intraoperatively was found to be an infolding of the pes anserinus and periosteum. Tibia valga occurred postoperatively because of asymmetrical physeal overgrowth and required corrective osteotomy.