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Hindawi Publishing Corporation
Case Reports in Orthopedics
Volume 2015, Article ID 783046, 3 pages
http://dx.doi.org/10.1155/2015/783046
Case Report
Bilateral Simultaneous Avulsion Fractures of the Proximal Tibia
in a 14-Year-Old Athlete with Vitamin-D Deficiency
Ziad Harb1 and Arfan Malhi2
1
Croydon University Hospital, London Road, Surrey CR7 7YE, UK
Lewisham & Greenwich NHS Trust, Lewisham High Street, London SE13 6LH, UK
2
Correspondence should be addressed to Ziad Harb; ziadharb@doctors.org.uk
Received 1 March 2015; Accepted 10 August 2015
Academic Editor: John Nyland
Copyright © 2015 Z. Harb and A. Malhi. This is an open access article distributed under the Creative Commons Attribution
License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly
cited.
Fractures involving the proximal tibial epiphysis are rare and form 0.5% of all epiphyseal injuries. The specific anatomical and
developmental features of the proximal tibial epiphysis make it vulnerable to unique patterns of fractures. Vitamin-D plays a
vital role in bone homeostasis and its deficiency has an impact on fracture risk and healing. We present the first ever reported
case of simultaneous bilateral proximal tibial physeal fractures in an athlete with vitamin-D deficiency. Treatment consisted of
plaster immobilisation, and the patient made a full recovery and returned to preinjury level of activities. We report this case for
its uniqueness and as an educational review of the importance of the developmental anatomy of the proximal tibia. We review the
literature and discuss how the stages of the growing physis determine the type of fracture sustained.
1. Introduction
2. Case Report
Fractures involving the proximal tibial epiphysis are rare and
form 0.5% of all epiphyseal injuries [1]. These fractures are
usually classified according to the Salter-Harris classification
or by the system...