PMC78999_01
The initial radiograph (lateral view) shows a slightly dislocated epiphysis of the proximal tibia with a metaphyseal fragment (Salter-Harris II).
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F1
Initial radiographs in three planes showed a slightly dislocated epiphysis of the proximal tibia with a metaphyseal fragment (Salter-Harris II), but no other osseous findings (Figures 1 and 2).
The initial radiograph (anterio-posterior view) reveals an opened physeal plate (medial) and a small metaphyseal fracture.
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F2
Initial radiographs in three planes showed a slightly dislocated epiphysis of the proximal tibia with a metaphyseal fragment (Salter-Harris II), but no other osseous findings (Figures 1 and 2).
Intraoperative fluoroscopy after reduction (lateral view).
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F3
Intraoperative films demonstrated restoration of accurate anatomic alignment of the bony fragments (Figures 3 and 4).
Intraoperative fluoroscopy after reduction (anterior-posterior view).
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F4
Intraoperative films demonstrated restoration of accurate anatomic alignment of the bony fragments (Figures 3 and 4).
Four weeks after the accident: the radiograph shows good alignment (lateral view).
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F5
MRI- and radiographic pictures in two planes showed no increased postreduction displacement and regular anatomical alignment of the fracture (Figures 5 and 6).
Four weeks after the accident: the radiograph shows good alignment and callus (antero-posterior view).
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F6
MRI- and radiographic pictures in two planes showed no increased postreduction displacement and regular anatomical alignment of the fracture (Figures 5 and 6).
Four weeks after the accident: the MRI shows an intact posterior cruciate ligament (hypodense).
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F7
Retrospective review of the previous MRI-films by an experienced colleague clearly depicted a previously missed rupture of the anterior cruciate ligament (ACL) with an enhanced signal of the tibial remainders of the ligament (Figure 7 and 8).
Four weeks after the accident: no anterior cruciate ligament can be detected. The MRI shows an enhanced signal of the tibial remainders of the ligament.
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F8
Retrospective review of the previous MRI-films by an experienced colleague clearly depicted a previously missed rupture of the anterior cruciate ligament (ACL) with an enhanced signal of the tibial remainders of the ligament (Figure 7 and 8).
Lateral radiograph after 1 year.
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F9
Eleven months after the trauma, complete healing of the fracture with correct alignment was confirmed (Figures 9 and 10).
Anterior-posterior radiograph after 1 year.
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F10
Eleven months after the trauma, complete healing of the fracture with correct alignment was confirmed (Figures 9 and 10).