title: Combined physeal/apophyseal fracture of the proximal tibia with anterior angulation from an indirect force: report of 2 cases.
abstract: Physeal fracture of the proximal tibia is a rare injury, comprising less than 2% of all physeal injuries. The literature distinguishes between tibial tubercle avulsions (apophyseal injuries) classified by Ogden, Tross, and Murphy as type I, II, and III and Salter-Harris II fractures. An extensive review of the literature located only 5 cases in which patients sustained a combined fracture of the proximal tibial physis and tibial tubercle. We report 2 such cases, which are not amenable to classification by current systems, and agree with Ryu and Debenham's suggestion to add a fourth type, avulsion hinge fracture of the proximal tibial epiphysis, to the Watson-Jones/Ogden classification.
authors.affiliation: St. Luke's-Roosevelt Hospital Center, New York, NY, USA.
authors.forename: Joseph P
authors.initials: JP
authors.lastname: Donahue
authors.forename: John F
authors.initials: JF
authors.lastname: Brennan
authors.forename: O Alton
authors.initials: OA
authors.lastname: Barron
mesh_terms: D000293:Adolescent; D001696:Biomechanical Phenomena; D006801:Humans; D007718:Knee Injuries / Q000145:classification / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery; D008297:Male; D011859:Radiography; D013978:Tibial Fractures / Q000145:classification / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery