EPIPHYSIS INJURY AROUND KNEE (FLEXION TYPE, SALTER-HARRIS TYPE 1)

Abstract

Introduction: Fractures of the proximal tibial and distal femur epiphysis rare. It has been estimated that fractures of the upper tibial and distal femur epiphysis account for 0.5-3.1% of all epiphyseal injuries. Who had no neurovascular decit, with xed extension deformity at the left knee was treated early with closed reduction techniques. We present a case of a adolscent child who develops injury while playing. The patient p Case Series: resented in emergency room with extremely swollen knee and soft tissue swelling (hemarthrosis), he was unable to lift his leg actively due to severe pain because of hamstrings spasm, and he had no wound over his left knee and had no other associated injuries. Plain radiographs were taken which revealed, separated proximal tibial and distal femur epiphysis (salter harris Type 1 injury) The epiphysis was anteriorly displaced fracture line extending beyond growth plate through metaphysis and tibial tuberosity also displaced anteriorly, no patellar fracture, radiograph also revealed no intra-articular fracture as joint appears congruent. Under spinal anesthesia, under all aseptic precautions traction was applied for few minutes, the fracture was reduced closed as the hamstring spasm gave way, reduction was conrmed under image intensier in both AP and lateral planes, and joint congruity was examined. Post-operative patient was immobilized with nil weight bearing for 4 weeks, check X-rays taken, he was mobilized in wheelchair. After 4 weeks slab was removed, K-wires were removed, and partial weight bearing was started with rehabilitation for full range of motion of the left knee. At 6 weeks, both the knee joints appeared symmetrical with no abnormalities or limb length discrepancy or instability with knee from 0° to 140°, with full weight bearing. Although Conclusion: less commonly seen, Salter-Harris Type 1 injuries to proximal tibial and dista femur physis, if managed early with closed reduction and xation, excellent long-term results can be achieved