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Case report: A rare Salter–Harris V metaphyseal fatigue fracture of the knee in an adolescent patient with obesity

Stress fractures are rare, occurring in 1.5/100,000 high school athletes. High impact, repetitive loading participation in woman's sports, and being a white athlete have been identified as risk factors for stress fractures. Mostly treated conservatively, they are more common in the tibia (33%)....

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Autores principales: Gao, Chao, Feng, Ling Le, Zheng, Jiang Hua, Cao, Jin, Sun, Hua Jing
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10323821/
https://www.ncbi.nlm.nih.gov/pubmed/37425269
http://dx.doi.org/10.3389/fped.2023.1209369
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author Gao, Chao
Feng, Ling Le
Zheng, Jiang Hua
Cao, Jin
Sun, Hua Jing
author_facet Gao, Chao
Feng, Ling Le
Zheng, Jiang Hua
Cao, Jin
Sun, Hua Jing
author_sort Gao, Chao
collection PubMed
description Stress fractures are rare, occurring in 1.5/100,000 high school athletes. High impact, repetitive loading participation in woman's sports, and being a white athlete have been identified as risk factors for stress fractures. Mostly treated conservatively, they are more common in the tibia (33%). Stress fractures requiring surgery, which are extremely rare, have been reported in the scaphoid, fifth metatarsal, and neck of femur. Herein, a 16-year-old adolescent patient with obesity presented with atypical knee pain after prolonged exercise. Advanced imaging revealed a stress fracture of the left tibia with a Salter–Harris type V fracture and varus deformity of the knee. We initially managed the fatigue fracture conservatively, followed by surgical correction of the varus deformity in the knee joint. The patient made a satisfactory recovery with equal limb length and no evidence of claudication. This is the first case of a proximal tibial metaphyseal stress fracture requiring surgery. The clinical manifestations of proximal tibial metaphyseal stress fractures and potential treatment strategies and the use of magnetic resonance for tibial stress fractures have been discussed. Understanding the location of unusual stress fractures can improve early diagnostic efficiency and reduce complication rates, healthcare costs, and recovery time.
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spelling pubmed-103238212023-07-07 Case report: A rare Salter–Harris V metaphyseal fatigue fracture of the knee in an adolescent patient with obesity Gao, Chao Feng, Ling Le Zheng, Jiang Hua Cao, Jin Sun, Hua Jing Front Pediatr Pediatrics Stress fractures are rare, occurring in 1.5/100,000 high school athletes. High impact, repetitive loading participation in woman's sports, and being a white athlete have been identified as risk factors for stress fractures. Mostly treated conservatively, they are more common in the tibia (33%). Stress fractures requiring surgery, which are extremely rare, have been reported in the scaphoid, fifth metatarsal, and neck of femur. Herein, a 16-year-old adolescent patient with obesity presented with atypical knee pain after prolonged exercise. Advanced imaging revealed a stress fracture of the left tibia with a Salter–Harris type V fracture and varus deformity of the knee. We initially managed the fatigue fracture conservatively, followed by surgical correction of the varus deformity in the knee joint. The patient made a satisfactory recovery with equal limb length and no evidence of claudication. This is the first case of a proximal tibial metaphyseal stress fracture requiring surgery. The clinical manifestations of proximal tibial metaphyseal stress fractures and potential treatment strategies and the use of magnetic resonance for tibial stress fractures have been discussed. Understanding the location of unusual stress fractures can improve early diagnostic efficiency and reduce complication rates, healthcare costs, and recovery time. Frontiers Media S.A. 2023-06-22 /pmc/articles/PMC10323821/ /pubmed/37425269 http://dx.doi.org/10.3389/fped.2023.1209369 Text en © 2023 Gao, Feng, Zheng, Cao and Sun. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) (https://creativecommons.org/licenses/by/4.0/) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Pediatrics
Gao, Chao
Feng, Ling Le
Zheng, Jiang Hua
Cao, Jin
Sun, Hua Jing
Case report: A rare Salter–Harris V metaphyseal fatigue fracture of the knee in an adolescent patient with obesity
title Case report: A rare Salter–Harris V metaphyseal fatigue fracture of the knee in an adolescent patient with obesity
title_full Case report: A rare Salter–Harris V metaphyseal fatigue fracture of the knee in an adolescent patient with obesity
title_fullStr Case report: A rare Salter–Harris V metaphyseal fatigue fracture of the knee in an adolescent patient with obesity
title_full_unstemmed Case report: A rare Salter–Harris V metaphyseal fatigue fracture of the knee in an adolescent patient with obesity
title_short Case report: A rare Salter–Harris V metaphyseal fatigue fracture of the knee in an adolescent patient with obesity
title_sort case report: a rare salter–harris v metaphyseal fatigue fracture of the knee in an adolescent patient with obesity
topic Pediatrics
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10323821/
https://www.ncbi.nlm.nih.gov/pubmed/37425269
http://dx.doi.org/10.3389/fped.2023.1209369
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