Journal of pediatric orthopedics
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Avulsion fracture of the tibial tubercle is an uncommon but severe injury of the proximal tibial physis in adolescents. These fractures are all Salter Type III injuries. The fracture line may extend through the proximal tibial articular surface. ⋯ Five of eight injuries were treated with open reduction and internal fixation. When the proximal tibial articular surface was involved in the fracture, anatomic reduction was the primary goal. This review demonstrates that this particular epiphyseal plate injury in the adolescent knee heals well without deformity or functional loss once adequate reduction and fixation of the fracture fragments have been achieved.
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A series of 40 young patients with lumbar spondylolisthesis is presented. The patients were treated surgically using osteoperiosteal transplants as the fusion material. In 29 patients, the fusion was posterior and in 11 patients posterolateral. ⋯ The best results were obtained using posterior fusion, while the rate of nonunion was higher in the posterolateral group. The periosteum was taken from the anteromedial aspect of the tibia using a sharp chisel. The method gives clinical and radiological results comparable with those obtained using bone transplants.