Fractures del cap humeral

1

Introduction

• The anterior tibial tuberosity is a very few
  frequent fracture (1 each 4 years).
• This fracture represents the 3 of the tibial
  fractures and 1 of the physeal fractures.
• It affects a athletics boys whose are between 14
  and 17 years old.
• We show our experience in this kind of
  fractures.
• We use a technique with parallel screws to the
  proximal tibial physis.

2

Material Methods

• Retrospective study
• Revision in the Vall dHebron Hospital in the
  last 10 years.
• Revision in a football clinic in the last 3
  years.
• We use screws or K-wire situated parallel to the
  tibial physis to avoid the fusion at this point.

screws
3

Results

• You collect nineteen fractures, all of them
  male. .
• In 14 patients (73.7) was affected the left
  side.
• All the fractures were closed.
• We use the Ogden classification .
• Three patient were treated with cast
  immobilization and 16 received surgery.
• We used screws in 80 of the patients and
  K-wires in 20 of the cases.
• We use a cast immobilization for five weeks.
• Only in one case we practiced a fasciotomy.
• Only two patients didnt need rehabilitation
  program. The ROM was full in all the cases.
• We have no compliations as infection or
  compartmental syndrome.
• During the follow-up, we did not have any case
  with early physeal closure and no case with genu
  recurvatum.
• 50 of the patients need a second surgery to
  remove the internal fixation

4

Results
5

Results
6

Results. Use k-wire
7

Results. Use Screws
8

Results. Use Screws
9

Conclusions

• The surgery treatment is safe.
• The treatment has to achive four objectives
• Anatomical reduction of the articular fracture
• No alteration of the physeal development
• Keeping the patella height
• Stable osteosynthesis.
• Our technique with parallel osteosynthesis give
  us an anatomical reduction, non epifisiodesis
  full ROM.
• It is not necessary to remove the material in
  all the cases.