Display options
Cite
Yadav R, Kasotya D, Goel A, et al. Salter-Harris I Injury of the Proximal Tibial Physis with Vascular Compromise: A Case Report and Review of Literature. J Orthop Case Rep. 2021;11(7):86-89doi: 10.13107/jocr.2021.v11.i07.2330.
Yadav, R., Kasotya, D., Goel, A., Bhatia, N., & Yadav, V. (2021). Salter-Harris I Injury of the Proximal Tibial Physis with Vascular Compromise: A Case Report and Review of Literature. Journal of orthopaedic case reports, 11(7), 86-89. https://doi.org/10.13107/jocr.2021.v11.i07.2330
Yadav, Rajeev, et al. "Salter-Harris I Injury of the Proximal Tibial Physis with Vascular Compromise: A Case Report and Review of Literature." Journal of orthopaedic case reports vol. 11,7 (2021): 86-89. doi: https://doi.org/10.13107/jocr.2021.v11.i07.2330
Yadav R, Kasotya D, Goel A, Bhatia N, Yadav V. Salter-Harris I Injury of the Proximal Tibial Physis with Vascular Compromise: A Case Report and Review of Literature. J Orthop Case Rep. 2021 Jul;11(7):86-89. doi: 10.13107/jocr.2021.v11.i07.2330. PMID: 34790612; PMCID: PMC8576765.
Copy Download .nbib Format: NLM
Share it on

J Orthop Case Rep. 2021 Jul;11(7):86-89. doi: 10.13107/jocr.2021.v11.i07.2330.

Salter-Harris I Injury of the Proximal Tibial Physis with Vascular Compromise: A Case Report and Review of Literature.

Journal of orthopaedic case reports

Rajeev Yadav, Devender Kasotya, Akash Goel, Nishant Bhatia, Vedpal Yadav

Affiliations

  1. Department of Orthopaedic Surgery, Maulana Azad Medical College and Associated Lok Nayak Hospital, New Delhi, India.

PMID: 34790612 PMCID: PMC8576765 DOI: 10.13107/jocr.2021.v11.i07.2330

Abstract

INTRODUCTION: Physeal injuries of proximal tibia are uncommon and constitute only 1% of all physeal injuries. Major vessel injuries are also rare in children and occur in 0.6% trauma cases, out of which, injuries of popliteal artery comprise only 5%. The combination of these is an extremely rare injury pattern but is potentially limb threatening. Most of the cases of physeal injuries of proximal tibia along with popliteal artery compromise, reported in the literature include Salter Harris (SH) type II, III, and IV patterns (type II being most common) with pure type I being extremely rare.

CASE REPORT: We describe a rare posteriorly displaced pure SH I injury of proximal tibial physis with compromised vascularity of the limb. Immediate closed reduction and stabilization with Kirschner wires (K-wires) restored the vascularity of the limb and the patient went on to have a good functional recovery at the last follow-up of 1 year.

CONCLUSION: Vascular injuries occurring in SH 1 proximal tibial physeal fractures are often overlooked or missed due to the relatively benign appearance of slip with no sharp fragments to injure major vessels. Close monitoring of neurovascular status and a low threshold for fixation, for example, with K-wires, are important to prevent limb threatening ischemia in these relatively simple appearing injuries.

Copyright: © Indian Orthopaedic Research Group.

Keywords: Hyperextension injury; Salter-Harris 1; physeal injury; proximal tibia; vascular injury

Conflict of interest statement

Conflict of Interest: Nil

References

  1. J Bone Joint Surg Am. 1979 Oct;61(7):996-1002 - PubMed
  2. J Pediatr Orthop. 1994 Jul-Aug;14(4):423-30 - PubMed
  3. Arch Orthop Trauma Surg. 1991;110(6):301-6 - PubMed
  4. J Orthop Surg Res. 2009 Jun 29;4:23 - PubMed
  5. J Bone Joint Surg Am. 1979 Mar;61(2):167-73 - PubMed
  6. Chin J Traumatol. 2015;18(4):238-40 - PubMed
  7. Am J Surg. 1990 Sep;160(3):287-90 - PubMed
  8. J Am Acad Orthop Surg. 2002 Sep-Oct;10(5):345-55 - PubMed
  9. Arch Orthop Trauma Surg. 1998;118(1-2):37-41 - PubMed
  10. Injury. 1984 Jul;16(1):49-50 - PubMed
  11. J Pediatr Orthop B. 2018 Jan;27(1):35-39 - PubMed
  12. J Orthop Traumatol. 2012 Mar;13(1):7-11 - PubMed
  13. J Child Orthop. 2009 Jun;3(3):191-7 - PubMed
  14. Acta Orthop Belg. 2016 Dec;82(4):918-922 - PubMed
  15. J Am Acad Orthop Surg. 2015 Sep;23(9):571-80 - PubMed
  16. J Pediatr Orthop B. 2010 Nov;19(6):492-6 - PubMed
  17. Injury. 1989 Mar;20(2):111-3 - PubMed
  18. J Pediatr Surg. 2010 Jul;45(7):1404-12 - PubMed

Publication Types