User login
Dr Patterson, editor of “Challenges in Sports Medicine and Orthopedics,” is a sports medicine physician at Florida Sports Injury in Clermont, Florida. Dr Patterson is board certified in family medicine and spinal cord injury medicine, and is a member of the faculty of sports and exercise medicine of the Royal College of Surgeons in Ireland.
|
|
A 5-year-old boy presented to the ED after sustaining an injury to his left leg during play with a friend. He was unable to bear weight on the left foot and had a visible deformity to his lower extremity. The left foot was neurovascularly intact. Radiographs were completed (Figures 1 and 2).
What is your interpretation of the following radiographs?
Answer
|
|
The radiographs revealed a 20˚ anteriorly (apex posterior) angulated fracture through the metaphysis of the distal tibia and fibula. Angulated distal tibia fractures in adults are usually fixed with surgery; however, in children, displaced or angulated fractures to long bones such as the tibia stimulate a significant amount of growth. In treating pediatric patients, there is a greater amount of acceptable angulation the closer a fracture is to the end of bone.1
The patient in this case was placed in a long leg cast, and the fractures were reduced with three-point fixation technique. He remained in the cast for 5 weeks; thereafter, a below-the-knee orthopedic walking boot was placed for 3 weeks. The radiographs in Figures 3 and 4, taken 8 weeks after initiation of treatment, show a healed distal tibia and fibula fracture with an acceptable 7˚ of anterior angulation.
Dr Patterson, editor of “Challenges in Sports Medicine and Orthopedics,” is a sports medicine physician at Florida Sports Injury in Clermont, Florida. Dr Patterson is board certified in family medicine and spinal cord injury medicine, and is a member of the faculty of sports and exercise medicine of the Royal College of Surgeons in Ireland.
|
|
A 5-year-old boy presented to the ED after sustaining an injury to his left leg during play with a friend. He was unable to bear weight on the left foot and had a visible deformity to his lower extremity. The left foot was neurovascularly intact. Radiographs were completed (Figures 1 and 2).
What is your interpretation of the following radiographs?
Answer
|
|
The radiographs revealed a 20˚ anteriorly (apex posterior) angulated fracture through the metaphysis of the distal tibia and fibula. Angulated distal tibia fractures in adults are usually fixed with surgery; however, in children, displaced or angulated fractures to long bones such as the tibia stimulate a significant amount of growth. In treating pediatric patients, there is a greater amount of acceptable angulation the closer a fracture is to the end of bone.1
The patient in this case was placed in a long leg cast, and the fractures were reduced with three-point fixation technique. He remained in the cast for 5 weeks; thereafter, a below-the-knee orthopedic walking boot was placed for 3 weeks. The radiographs in Figures 3 and 4, taken 8 weeks after initiation of treatment, show a healed distal tibia and fibula fracture with an acceptable 7˚ of anterior angulation.
Dr Patterson, editor of “Challenges in Sports Medicine and Orthopedics,” is a sports medicine physician at Florida Sports Injury in Clermont, Florida. Dr Patterson is board certified in family medicine and spinal cord injury medicine, and is a member of the faculty of sports and exercise medicine of the Royal College of Surgeons in Ireland.
|
|
A 5-year-old boy presented to the ED after sustaining an injury to his left leg during play with a friend. He was unable to bear weight on the left foot and had a visible deformity to his lower extremity. The left foot was neurovascularly intact. Radiographs were completed (Figures 1 and 2).
What is your interpretation of the following radiographs?
Answer
|
|
The radiographs revealed a 20˚ anteriorly (apex posterior) angulated fracture through the metaphysis of the distal tibia and fibula. Angulated distal tibia fractures in adults are usually fixed with surgery; however, in children, displaced or angulated fractures to long bones such as the tibia stimulate a significant amount of growth. In treating pediatric patients, there is a greater amount of acceptable angulation the closer a fracture is to the end of bone.1
The patient in this case was placed in a long leg cast, and the fractures were reduced with three-point fixation technique. He remained in the cast for 5 weeks; thereafter, a below-the-knee orthopedic walking boot was placed for 3 weeks. The radiographs in Figures 3 and 4, taken 8 weeks after initiation of treatment, show a healed distal tibia and fibula fracture with an acceptable 7˚ of anterior angulation.