BACKGROUND Avulsion fracture of the ischial tuberosity is a relatively clinically rare type of trauma that is mainly incurred by adolescents during competitive sports activities.According to previous literature,the mo...BACKGROUND Avulsion fracture of the ischial tuberosity is a relatively clinically rare type of trauma that is mainly incurred by adolescents during competitive sports activities.According to previous literature,the most commonly involved sports are soccer,sprinting,and gymnastics,in descending order.Dance-induced avulsion fracture of the ischial tuberosity and ischial ramus is extremely clinically rare.CASE SUMMARY A case of a neglected avulsion fracture of the ischial tuberosity and ischial ramus was diagnosed in a young female dancer who complained of pain and restricted movement of her right hip.She stated that she had suffered the injury while performing a split leap during a dance performance 9 mo prior.Eventually,she underwent surgery and obtained satisfactory treatment results.CONCLUSION Early diagnosis of these fractures is important to ensuring early proper treatment towards a quicker recovery.For old fractures with nonunion and chronic buttock pain,surgery is a preferred therapeutic choice with good treatment outcomes.展开更多
BACKGROUND Most greater tuberosity fractures can be treated without surgery but some have a poor prognosis.The surgical procedures for avulsion fractures of the humeral greater tuberosity include screw fixation,suture...BACKGROUND Most greater tuberosity fractures can be treated without surgery but some have a poor prognosis.The surgical procedures for avulsion fractures of the humeral greater tuberosity include screw fixation,suture anchor fixation,and plate fixation,all of which have treatment-associated complications.To decrease surgical complications,we used a modified suture bridge procedure under direct vision and a minimally invasive small incision to fix fractures of the greater tuberosity of the humerus.AIM To investigate the clinical efficacy and outcomes of minimally invasive modified suture bridge open reduction of greater tuberosity evulsion fractures.METHODS Sixteen patients diagnosed between January 2016 and January 2019 with an avulsion-type greater tuberosity fracture of the proximal humerus and treated by minimally invasive open reduction and modified suture bridges with anchors were studied retrospectively.All were followed up by clinical examination and radiographs at 3 and 6 wk,3,6 and 12 mo after surgery,and thereafter every 6 mo.Outcomes were assessed preoperatively and postoperatively by a visual analog scale(VAS),the University of California Los Angeles(UCLA)shoulder score,the American Shoulder and Elbow Surgeon score(ASES),and range of motion(ROM)for shoulders.RESULTS Seven men and nine women,with an average age of 44.94 years,were evaluated.The time between injury and surgery was 1-2 d,with an average of 1.75 d.The mean operation time was 103.1±7.23 min.All patients achieved bone union within 3 mo after surgery.VAS scores were significantly decreased(P=0.002),and the mean degrees of forward elevation(P=0.047),mean degrees of abduction(P=0.035),ASES score(P=0.092)were increased at 3 wk.The UCLA score was increased at 6 wk(P=0.029)after surgery.The average degrees of external rotation and internal rotation both improved at 3 mo after surgery(P=0.012 and P=0.007,respectively).No procedure-related deaths or incision-related superficial or deep tissue infections occurred.CONCLUSION Modified suture bridge was effective for the treatment of greater tuberosity evulsion fractures,was easier to perform,and had fewer implants than other procedures.展开更多
BACKGROUND Few cases of avulsion fractures of the tibial tuberosity with simultaneous rupture of the patellar tendon have been reported in the literature.Therefore,its mechanism and incidence have not been determined ...BACKGROUND Few cases of avulsion fractures of the tibial tuberosity with simultaneous rupture of the patellar tendon have been reported in the literature.Therefore,its mechanism and incidence have not been determined conclusively.This type of fracture is considered a serious injury that requires prompt diagnosis and early surgical repair.There is no therapeutic algorithm or standard method of treatment due to the infrequency of the injury.In this case report,we conducted an exhaustive review and synthesis of the existing literature including all previously reported cases.CASE SUMMARY We present a 16-year-old male soccer player with a case of a tibial tuberosity fracture with distal avulsion of the patellar tendon 5 d prior to surgical treatment.The patient presented with a loss of the extensor mechanism of the knee,edema,the inability to walk,and pain.X-rays showed a high patella and a 180-degree avulsion of the tibial tuberosity.The diagnosis was confirmed by magnetic resonance imaging and computed tomography.The patient underwent open reduction and internal fixation of the fracture with a cannulated screw and washer as well as patellar tendon repair with two metallic anchors.The rehabilitation protocol consisted of initial immobilization in extension followed by passive mobility and muscle strengthening exercises.The patient demonstrated excellent postoperative outcomes and returned to regular activity without complications.CONCLUSION This case presentation and literature review comprise the most relevant clinical,radiographic,and treatment details described in the international literature to date,providing the reader with an overview of this rare condition.展开更多
Fractures of the lesser tuberosity of the humerus are typically met in combination with other injuries of the shoulder. Case reports of isolated lesser tuberosity fractures are particularly rare and, consequently,ther...Fractures of the lesser tuberosity of the humerus are typically met in combination with other injuries of the shoulder. Case reports of isolated lesser tuberosity fractures are particularly rare and, consequently,therapeutic protocols have not yet been completely clarified. Conservative as well as surgical treatment has been recommended, while several operative techniques have been applied. We present a case of a 39-yearold man with an isolated lesser tuberosity fracture who was treated surgically in our institution. Due to fracture comminution, a two-level reconstruction technique with headless screws and buttress plate was applied. As far as we know, this method of fixation of this type of fracture has not been previously described in the literature.The patient tolerated the procedure well and excellent results were obtained at the latest follow-up.展开更多
Adolescent tibial tuberosity injuries are infrequent fractures usually seen in physically active adolescent males. Powerful contraction of the knee extensors by sudden acceleration or deceleration of the quadriceps mu...Adolescent tibial tuberosity injuries are infrequent fractures usually seen in physically active adolescent males. Powerful contraction of the knee extensors by sudden acceleration or deceleration of the quadriceps muscle can result in avulsion fractures of the tibial tuberosity apophysis. In late puberty, as the growth plate closes, it is transiently replaced by fibrocartilaginous elements. This transition causes a period of weakened tensile strength, which predisposes the tibial tuberosity to traction injury. Classification of tibial tuberosity fractures includes types I-V with added A and B subsets to types I, II and III. Multidetector computed tomography (MDCT) is a useful tool to more accurately classify complex, higher grade adolescent tibial tuberosity avulsion fractures when compared to plain film. This aids in preoperative planning and, therefore, results in improved treatment and management.展开更多
文摘BACKGROUND Avulsion fracture of the ischial tuberosity is a relatively clinically rare type of trauma that is mainly incurred by adolescents during competitive sports activities.According to previous literature,the most commonly involved sports are soccer,sprinting,and gymnastics,in descending order.Dance-induced avulsion fracture of the ischial tuberosity and ischial ramus is extremely clinically rare.CASE SUMMARY A case of a neglected avulsion fracture of the ischial tuberosity and ischial ramus was diagnosed in a young female dancer who complained of pain and restricted movement of her right hip.She stated that she had suffered the injury while performing a split leap during a dance performance 9 mo prior.Eventually,she underwent surgery and obtained satisfactory treatment results.CONCLUSION Early diagnosis of these fractures is important to ensuring early proper treatment towards a quicker recovery.For old fractures with nonunion and chronic buttock pain,surgery is a preferred therapeutic choice with good treatment outcomes.
基金China Scholarship Council,No.201808080126Incubation Fund of Shandong Provincial Hospital,No.2020FY019+1 种基金Young Scholars Program of Shandong Provincial HospitalNatural Science Foundation of Shandong Province,No.ZR202102180575.
文摘BACKGROUND Most greater tuberosity fractures can be treated without surgery but some have a poor prognosis.The surgical procedures for avulsion fractures of the humeral greater tuberosity include screw fixation,suture anchor fixation,and plate fixation,all of which have treatment-associated complications.To decrease surgical complications,we used a modified suture bridge procedure under direct vision and a minimally invasive small incision to fix fractures of the greater tuberosity of the humerus.AIM To investigate the clinical efficacy and outcomes of minimally invasive modified suture bridge open reduction of greater tuberosity evulsion fractures.METHODS Sixteen patients diagnosed between January 2016 and January 2019 with an avulsion-type greater tuberosity fracture of the proximal humerus and treated by minimally invasive open reduction and modified suture bridges with anchors were studied retrospectively.All were followed up by clinical examination and radiographs at 3 and 6 wk,3,6 and 12 mo after surgery,and thereafter every 6 mo.Outcomes were assessed preoperatively and postoperatively by a visual analog scale(VAS),the University of California Los Angeles(UCLA)shoulder score,the American Shoulder and Elbow Surgeon score(ASES),and range of motion(ROM)for shoulders.RESULTS Seven men and nine women,with an average age of 44.94 years,were evaluated.The time between injury and surgery was 1-2 d,with an average of 1.75 d.The mean operation time was 103.1±7.23 min.All patients achieved bone union within 3 mo after surgery.VAS scores were significantly decreased(P=0.002),and the mean degrees of forward elevation(P=0.047),mean degrees of abduction(P=0.035),ASES score(P=0.092)were increased at 3 wk.The UCLA score was increased at 6 wk(P=0.029)after surgery.The average degrees of external rotation and internal rotation both improved at 3 mo after surgery(P=0.012 and P=0.007,respectively).No procedure-related deaths or incision-related superficial or deep tissue infections occurred.CONCLUSION Modified suture bridge was effective for the treatment of greater tuberosity evulsion fractures,was easier to perform,and had fewer implants than other procedures.
文摘BACKGROUND Few cases of avulsion fractures of the tibial tuberosity with simultaneous rupture of the patellar tendon have been reported in the literature.Therefore,its mechanism and incidence have not been determined conclusively.This type of fracture is considered a serious injury that requires prompt diagnosis and early surgical repair.There is no therapeutic algorithm or standard method of treatment due to the infrequency of the injury.In this case report,we conducted an exhaustive review and synthesis of the existing literature including all previously reported cases.CASE SUMMARY We present a 16-year-old male soccer player with a case of a tibial tuberosity fracture with distal avulsion of the patellar tendon 5 d prior to surgical treatment.The patient presented with a loss of the extensor mechanism of the knee,edema,the inability to walk,and pain.X-rays showed a high patella and a 180-degree avulsion of the tibial tuberosity.The diagnosis was confirmed by magnetic resonance imaging and computed tomography.The patient underwent open reduction and internal fixation of the fracture with a cannulated screw and washer as well as patellar tendon repair with two metallic anchors.The rehabilitation protocol consisted of initial immobilization in extension followed by passive mobility and muscle strengthening exercises.The patient demonstrated excellent postoperative outcomes and returned to regular activity without complications.CONCLUSION This case presentation and literature review comprise the most relevant clinical,radiographic,and treatment details described in the international literature to date,providing the reader with an overview of this rare condition.
文摘Fractures of the lesser tuberosity of the humerus are typically met in combination with other injuries of the shoulder. Case reports of isolated lesser tuberosity fractures are particularly rare and, consequently,therapeutic protocols have not yet been completely clarified. Conservative as well as surgical treatment has been recommended, while several operative techniques have been applied. We present a case of a 39-yearold man with an isolated lesser tuberosity fracture who was treated surgically in our institution. Due to fracture comminution, a two-level reconstruction technique with headless screws and buttress plate was applied. As far as we know, this method of fixation of this type of fracture has not been previously described in the literature.The patient tolerated the procedure well and excellent results were obtained at the latest follow-up.
文摘Adolescent tibial tuberosity injuries are infrequent fractures usually seen in physically active adolescent males. Powerful contraction of the knee extensors by sudden acceleration or deceleration of the quadriceps muscle can result in avulsion fractures of the tibial tuberosity apophysis. In late puberty, as the growth plate closes, it is transiently replaced by fibrocartilaginous elements. This transition causes a period of weakened tensile strength, which predisposes the tibial tuberosity to traction injury. Classification of tibial tuberosity fractures includes types I-V with added A and B subsets to types I, II and III. Multidetector computed tomography (MDCT) is a useful tool to more accurately classify complex, higher grade adolescent tibial tuberosity avulsion fractures when compared to plain film. This aids in preoperative planning and, therefore, results in improved treatment and management.
