RESUMO
Introduction: Tibial tubercle osteotomy (TTO) is a surgical procedure commonly used. Several local postoperative complications have been identified in the literature, such as early proximal tibial fractures. In exceptional cases, these fractures can occur later in the postoperative period, i.e., after 6 months. The current paper described a case study of this rare delayed complication. Case Report: An athletic 24-year-old military man was admitted to the emergency department following a spontaneous proximal tibial fracture below and arising from the TTO site realized 7 months earlier. Conclusion: Delayed spontaneous fractures of the proximal tibia following TTO are extremely rare complications. This paper describes a case of delayed spontaneous fracture in a young athlete. Factors contributing to this fracture are analyzed. An adaptation of the surgical technique and rehabilitation protocol is discussed.
RESUMO
The occurrence of a pathological fracture in children requires a rigorous diagnostic approach in order to establish the etiology and to develop a precise therapeutic strategy. Several causes are associated with these fractures, the most frequent being benign tumors in children in developed countries and chronic osteomyelitis in developing countries. More rarely, malignant tumors must however always be considered. The differential diagnosis on imaging may be difficult to establish between bone tumors and chronic infection. Surgical biopsy is therefore often performed to establish the precise origin of the fracture. We report the case of an adamantinoma (osteofibrous dysplasia-like) of the fibula in a 7-year-old child, discovered during the management of a pathologic fracture. The presumed diagnosis before biopsy was chronic osteomyelitis. A 14-cm-resection of the affected fibula was performed with good functional result. Differential diagnosis between adamantinoma, osteofibrous dysplasia and osteofibrous dysplasia-like adamantinoma remains very challenging.