Combined physeal/apophyseal fracture of the proximal tibia with anterior angulation from an indirect force: report of 2 cases. American journal of orthopedics (Belle Mead, N.J.) Donahue, J. P., Brennan, J. F., Barron, O. A. 2003; 32 (12): 604-7

Abstract

Physeal fracture of the proximal tibia is a rare injury, comprising less than 2% of all physeal injuries. The literature distinguishes between tibial tubercle avulsions (apophyseal injuries) classified by Ogden, Tross, and Murphy as type I, II, and III and Salter-Harris II fractures. An extensive review of the literature located only 5 cases in which patients sustained a combined fracture of the proximal tibial physis and tibial tubercle. We report 2 such cases, which are not amenable to classification by current systems, and agree with Ryu and Debenham's suggestion to add a fourth type, avulsion hinge fracture of the proximal tibial epiphysis, to the Watson-Jones/Ogden classification.

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