Multi-Ligament Knee Injury with Concomitant Tibial Tubercle Fracture: A Challenging Case Report and Review of the Pertinent Literature
Background: Multi-ligament knee injury (MLKI) combined with a comminuted tibial tubercle avulsion fracture in the literature has been reported as a very rare condition. To the best of our knowledge, there was no case report of this condition associated with open proximal tibia fractures. Cas...
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| Format: | Article |
| Language: | English |
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Tehran University of Medical Sciences
2021-03-01
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| Series: | Journal of Orthopedic and Spine Trauma |
| Subjects: | |
| Online Access: | https://jost.tums.ac.ir/index.php/jost/article/view/231 |
| _version_ | 1818888175574056960 |
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| author | Seyed Mohammad Tahami Arash Sharafatvaziri Mohammad Naghi Tahmasebi Fardis Vosoughi Majid Khalilzad Rasool Safari |
| author_facet | Seyed Mohammad Tahami Arash Sharafatvaziri Mohammad Naghi Tahmasebi Fardis Vosoughi Majid Khalilzad Rasool Safari |
| author_sort | Seyed Mohammad Tahami |
| collection | DOAJ |
| description | Background: Multi-ligament knee injury (MLKI) combined with a comminuted tibial tubercle avulsion fracture in the literature has been reported as a very rare condition. To the best of our knowledge, there was no case report of this condition associated with open proximal tibia fractures.
Case Report: A 32-year-old man was referred to our center, with a comminuted tibial tubercle fracture, patella alta, fracture of the tibia at the proximal meta-diaphyseal junction, a Segond fracture, and proximal tibiofibular dislocation on X-ray images. Further assessment of intra-articular pathologies was performed during the operation and complete tear of anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) tear were identified. Radial tear of the body and anterior root avulsion of medial meniscus were also noted. All of the extra-articular and intra-articular injuries were addressed surgically, except ACL and PCL tear, which were postponed to a second stage. Proximal tibiofibular dislocation was not approached surgically. The rehabilitation protocol included 6 weeks of non-weight-bearing followed by 6 weeks of crutch-assisted partial weight-bearing ambulation, and forbidden active knee extension during the first 6 weeks and allowing the patient to perform passive flexion of the knee to 90 degrees starting from the second week. Following the rehabilitation program, the patient achieved near-full range of motion (ROM) by the end of 6 months of clinical follow-up.
Conclusion: By means of our specific surgical technique and post-operative rehabilitation protocol, we led the patient with this specific condition to have fracture union and near-normal ROM by the end of 6 months. |
| first_indexed | 2024-12-19T16:48:57Z |
| format | Article |
| id | doaj.art-9bdf2ee0e2b94952adf783478b92c49b |
| institution | Directory Open Access Journal |
| issn | 2538-2330 2538-4600 |
| language | English |
| last_indexed | 2024-12-19T16:48:57Z |
| publishDate | 2021-03-01 |
| publisher | Tehran University of Medical Sciences |
| record_format | Article |
| series | Journal of Orthopedic and Spine Trauma |
| spelling | doaj.art-9bdf2ee0e2b94952adf783478b92c49b2022-12-21T20:13:36ZengTehran University of Medical SciencesJournal of Orthopedic and Spine Trauma2538-23302538-46002021-03-016410.18502/jost.v6i4.5567Multi-Ligament Knee Injury with Concomitant Tibial Tubercle Fracture: A Challenging Case Report and Review of the Pertinent LiteratureSeyed Mohammad Tahami0Arash Sharafatvaziri1Mohammad Naghi Tahmasebi2Fardis Vosoughi3Majid Khalilzad4Rasool Safari5Department of Orthopedic Surgery, Bone and Joint Research Center, Chamran Hospital, Shiraz University of Medical Sciences, Shiraz, IranDepartment of Orthopedic Surgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, IranDepartment of Orthopedic Surgery, Shariati Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, IranDepartment of Orthopedic Surgery, Shariati Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, IranDepartment of Orthopedic and Trauma Surgery, Shariati Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran; Department of Orthopedic Surgery, Shahid Beheshti Hospital, Babol University of Medical Sciences, Babol, IranDepartment of Orthopaedic Surgery, Bone and Joint Research Center, Chamran Hospital, Shiraz University of Medical Sciences, Shiraz, IranBackground: Multi-ligament knee injury (MLKI) combined with a comminuted tibial tubercle avulsion fracture in the literature has been reported as a very rare condition. To the best of our knowledge, there was no case report of this condition associated with open proximal tibia fractures. Case Report: A 32-year-old man was referred to our center, with a comminuted tibial tubercle fracture, patella alta, fracture of the tibia at the proximal meta-diaphyseal junction, a Segond fracture, and proximal tibiofibular dislocation on X-ray images. Further assessment of intra-articular pathologies was performed during the operation and complete tear of anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) tear were identified. Radial tear of the body and anterior root avulsion of medial meniscus were also noted. All of the extra-articular and intra-articular injuries were addressed surgically, except ACL and PCL tear, which were postponed to a second stage. Proximal tibiofibular dislocation was not approached surgically. The rehabilitation protocol included 6 weeks of non-weight-bearing followed by 6 weeks of crutch-assisted partial weight-bearing ambulation, and forbidden active knee extension during the first 6 weeks and allowing the patient to perform passive flexion of the knee to 90 degrees starting from the second week. Following the rehabilitation program, the patient achieved near-full range of motion (ROM) by the end of 6 months of clinical follow-up. Conclusion: By means of our specific surgical technique and post-operative rehabilitation protocol, we led the patient with this specific condition to have fracture union and near-normal ROM by the end of 6 months.https://jost.tums.ac.ir/index.php/jost/article/view/231Ligament; Knee; Fracture; Tibia |
| spellingShingle | Seyed Mohammad Tahami Arash Sharafatvaziri Mohammad Naghi Tahmasebi Fardis Vosoughi Majid Khalilzad Rasool Safari Multi-Ligament Knee Injury with Concomitant Tibial Tubercle Fracture: A Challenging Case Report and Review of the Pertinent Literature Journal of Orthopedic and Spine Trauma Ligament; Knee; Fracture; Tibia |
| title | Multi-Ligament Knee Injury with Concomitant Tibial Tubercle Fracture: A Challenging Case Report and Review of the Pertinent Literature |
| title_full | Multi-Ligament Knee Injury with Concomitant Tibial Tubercle Fracture: A Challenging Case Report and Review of the Pertinent Literature |
| title_fullStr | Multi-Ligament Knee Injury with Concomitant Tibial Tubercle Fracture: A Challenging Case Report and Review of the Pertinent Literature |
| title_full_unstemmed | Multi-Ligament Knee Injury with Concomitant Tibial Tubercle Fracture: A Challenging Case Report and Review of the Pertinent Literature |
| title_short | Multi-Ligament Knee Injury with Concomitant Tibial Tubercle Fracture: A Challenging Case Report and Review of the Pertinent Literature |
| title_sort | multi ligament knee injury with concomitant tibial tubercle fracture a challenging case report and review of the pertinent literature |
| topic | Ligament; Knee; Fracture; Tibia |
| url | https://jost.tums.ac.ir/index.php/jost/article/view/231 |
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