ABSTRACT
INTRODUCTION: Tibial plateau fractures are recognized as one of the most challenging orthopedic injuries, especially when encountered in adults with unfused growth plates. The rarity of such cases makes them significant for study and discussion. IMPORTANCE: The presence of an open growth plate in adult patients can significantly influence both treatment decisions and outcomes. Understanding these unique cases is vital, as they offer insights into managing similar future cases and advancing orthopedic care. CASE PRESENTATION: A 23-year-old male, following a car accident, presented with a closed knee injury. Radiographic evaluations, including a hand X-ray to determine skeletal age, were employed. The findings confirmed a Salter and Harris type 4 fracture of the proximal tibia and indicated a skeletal age of approximately 15 years ±6 months. Treatment involved open reduction and internal fixation, specifically tailored to account for the patient's preserved growth plate. CLINICAL DISCUSSION: Managing such fractures necessitates a specialized approach, ensuring the growth plate is not jeopardized during treatment. The patient's age, combined with the presence of an unfused growth plate, added complexity to the treatment plan. The emphasis on accurate classification of the fracture, the selected surgical technique, and post-operative care played a pivotal role in the successful recovery. CONCLUSION: This case underscores the importance of a holistic, multidisciplinary approach in managing rare orthopedic presentations. Ensuring the preservation of growth potential while achieving functional recovery is paramount. Such cases enrich the orthopedic literature, guiding future treatments and interventions.
ABSTRACT
INTRODUCTION: Osteo-articular tuberculosis is a rare manifestation of this disease, often posing diagnostic challenges that necessitate additional diagnostic imaging modalities such as radiography, CT, and MRI. This article presents a series of five cases involving tuberculosis affecting the bones of the foot and ankle, diagnosed at various stages. The patients received appropriate anti-tuberculosis medical treatment following national protocols, along with surgical interventions when necessary. CASE STUDIES: In this series, we describe the clinical characteristics and management of five cases of foot and ankle bone tuberculosis. These cases were diagnosed at different stages, and all patients received standard anti-tuberculosis medical therapy according to national treatment guidelines. Surgical interventions were performed when deemed necessary to optimize patient outcomes. DISCUSSION: The diagnosis of bone tuberculosis should be considered in any clinical scenario that presents with uncertain features, persistent symptoms, or resistance to conventional treatment approaches. It is crucial to employ a multidisciplinary approach involving medical and surgical management to effectively address this challenging disease. However, it is important to note that surgical intervention cannot replace the necessity of proper medical treatment. CONCLUSION: Tuberculosis involving the bones of the foot and ankle remains an infrequent occurrence. However, considering the endemic context, prompt therapeutic interventions are essential to prevent significant osteoarticular damage. Early diagnosis, adherence to established treatment protocols, and a comprehensive approach encompassing both medical and surgical modalities are crucial for successful management of this rare entity.
