Salter Harris III Medial Femoral Condyle Fracture with Concomitant Complete Anterior Cruciate Ligament Tear. A Case Report and Review of the Literature

摘要

Several reports in the literature detail a Salter-Harris III medial femoral condyle fracture caused by valgus stress. Many report delayed medial meniscal tears, early degenerative changes, and subsequent need for medial menisectomy. This may indicate that ACL injury in these patients goes unrecognized. This case report describes successful closed treatment of a Salter-Harris III medial femoral condyle fracture and a delayed ACL reconstruction, where all others in the literature advocate surgical treatment of the fracture. The indications for surgical management of the fracture and the literature on this combined injury are reviewed. Index of suspicion should remain high for the possibility of ligamentous instability associated with fractures about the knee in skeletally immature patients. The potential for further injury can be avoided by performing a thorough exam. Magnetic resonance imaging confirms situations where provocative ligament exams are limited by guarding and pain.