Growth plate fracture of the proximal tibia in a young adult with an unfused growth plate: A case report

Introduction: Tibial plateau fractures are recognized as one of the most challenging orthopedic injuries, especially when encountered in adults with unfused growth plates. The rarity of such cases makes them significant for study and discussion.Importance: The presence of an open growth plate in adult patients can significantly influence both treatment decisions and outcomes. Understanding these unique cases is vital, as they offer insights into managing similar future cases and advancing orthopedic care.Case presentation: A 23-year-old male, following a car accident, presented with a closed knee injury. Radiographic evaluations, including a hand X-ray to determine skeletal age, were employed. The findings confirmed a Salter and Harris type 4 fracture of the proximal tibia and indicated a skeletal age of approximately 15 years +/- 6 months. Treatment involved open reduction and internal fixation, specifically tailored to account for the patient's preserved growth plate.Clinical discussion: Managing such fractures necessitates a specialized approach, ensuring the growth plate is not jeopardized during treatment. The patient's age, combined with the presence of an unfused growth plate, added complexity to the treatment plan. The emphasis on accurate classification of the fracture, the selected surgical technique, and post-operative care played a pivotal role in the successful recovery.Conclusion: This case underscores the importance of a holistic, multidisciplinary approach in managing rare orthopedic presentations. Ensuring the preservation of growth potential while achieving functional recovery is paramount. Such cases enrich the orthopedic literature, guiding future treatments and interventions.