Simultaneous Bilateral Flexion-Type Salter-Harris II Fractures of the Proximal Tibia: A Case Report and Review of the Literature

Abstract

A rare case is reported of bilateral physeal lesions of the proximal tibia classified as Salter-Harris type II, which occurred simultaneously after a "flexion type" injury in a 14-year-old boy. Treatment was conservative on the nondisplaced side and surgical, by closed reduction and internal fixation, on the displaced side. There was no previous diagnosis of Osgood-Schlatter disease. After reviewing all the cases described previously, which occurred either consecutively or simultaneously, we conclude that less resistance of the growth plate, typical of late adolescence, likely represents the cause of this type of lesion.

Keywords: Bilateral physeal fractures; flexion-type.; proximal tibia.

Fig. (1)

Radiographic examination of simultaneous bilateral flexion-type Salter-Harris II fractures of the proximal tibia in a 14-year-old boy, non-displaced on the right side and displaced on the left (A-C). The patient was treated conservatively on the right side and surgically, by closed reduction and internal fixation with two cannulated screws, on the left (D-F). At follow-up, one year after the injury, the fractures were perfectly healed, with almost complete fusion of the proximal tibial physes (G-I). The patient had resumed playing basketball without any problem; he refused a second operation to remove the screws.