Traumatic plastic deformation of the tibia: case report and literature review

Abstract

Plastic deformation refers to the deformation of a bone, without fracture of its cortices, that persists once the deforming force has been removed. It is not a common condition but is seen more frequently in children than in adults. Of the cases published, there have been only three previous reports of tibial involvement, with the forearm being the most commonly affected site. We describe the case of a 10-year-old girl who, after falling down a slope, came to a sudden stop when her right foot hit a rock. This resulted in a fracture of the fibula and bowing of the tibia. We discuss the dilemmas faced in treatment and recommend regular follow up until the patient reaches skeletal maturity.

Figure 1

Initial anteroposterior (left) and lateral x-rays showing valgus plastic deformation of the tibia and a valgus fracture of the mid-shaft of the fibula

Figure 2

X-rays at eight weeks after the injury demonstrating a callus at the fibula fracture and a residual valgus deformity of the tibia of 7° (left) compared to the uninjured side

Figure 3

Photograph taken at six weeks after the injury showing no clinical deformity

Figure 4

Anteroposterior (left) and lateral x-rays taken at 22 months after the injury