RESUMEN
Simultaneous occurrence of tibial tubercle fracture and patellar tendon avulsion is an extremely rare condition. However, they have become more frequent due to increased participation in sports at a younger age. Diagnosis is not always straightforward, and treatment consists of open reduction and internal fixation. Only a few case reports of such injuries were reported in the literature with limited information according to diagnoses, treatment, and outcome in adolescents.
Asunto(s)
Fijación Interna de Fracturas/métodos , Fracturas por Avulsión , Ligamento Rotuliano , Traumatismos de los Tendones , Fracturas de la Tibia , Adolescente , Fracturas por Avulsión/diagnóstico , Fracturas por Avulsión/cirugía , Humanos , Traumatismos de la Rodilla/diagnóstico , Traumatismos de la Rodilla/fisiopatología , Traumatismos de la Rodilla/cirugía , Imagen por Resonancia Magnética/métodos , Masculino , Ligamento Rotuliano/lesiones , Ligamento Rotuliano/cirugía , Traumatismos de los Tendones/diagnóstico , Traumatismos de los Tendones/cirugía , Fracturas de la Tibia/diagnóstico , Fracturas de la Tibia/cirugía , Tomografía Computarizada por Rayos X/métodos , Resultado del TratamientoRESUMEN
PURPOSE: To describe the results of nonsurgical and surgical treatment of enchondromas of the distal phalanx of the hand. METHODS: Eleven enchondromas of the distal phalanx were retrospectively reviewed. Five patients underwent surgery (curettage and autogenous cancellous bone graft from the iliac crest) and 6 patients were treated nonsurgically. Clinical records and radiographs were reviewed for each patient. We recorded complications and cosmetic and functional results. Radiographic healing in surgical patients was scored according to the classification of Tordai and to the criteria of Wilhelm and Feldmeier. The average follow-up of the nonsurgical and surgical cases was 45 and 62 months, respectively. RESULTS: Eight patients were women. Average age at diagnosis was 40 years. Nine patients presented with a pathological fracture. The demographic characteristics of the surgical group and nonsurgical group were similar. Among the cases treated nonsurgically (6), 1 had 2 pathological fractures after diagnosis. At final follow-up, the average pain on a visual analog scale was 2.8. With the exception of 1 patient, the range of motion of the fingers was normal or minimally reduced. Among the surgical cases (5), there were no complications in the bone graft donor site, 2 patients developed infections in the operated finger, and no postoperative pathological fractures were found. At final follow-up, the average pain was 3.2. Joint mobility was normal in 3 patients. Postoperative radiological examination revealed complete bone healing in all patients (grade I in the Tordai classification). No local recurrence was seen. According to the criteria of Wilhelm and Feldmeier, there were 3 excellent, 1 good, and 1 satisfactory results in the surgical group, and 2 excellent, 3 good, and 1 satisfactory results in the nonsurgical group. CONCLUSIONS: Surgical and nonsurgical treatment in distal phalanx enchondromas appear to be associated with satisfactory results, although each has their own advantages and disadvantages. TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV.