Pediatrics & Therapeutics
Open Access
ISSN: 2161-0665
ISSN: 2161-0665
Noorhuda A M, Dinesh kumar C, Ismyth A R and Norzatulsyima N
Melaka General Hospital, Malaysia
Posters & Accepted Abstracts: Pediatr Ther
Introduction: Isolated PCL avulsion fracture is an uncommon injury in children. We report a case that was only 7 years old and was managed based on clinical judgement associated with subtle Xray findings. Case Report: A 7-year-old boy from rural area was a pillion rider when his father�??s motorbike was hit by a van from behind. He sustained pain over the left knee. There was bruising over the left shin, with diffuse tenderness and swelling over left knee. Xray showed a sliver of bone over the posterior knee. Patient was put up for examination under GA KIV screw fixation. Assessment under general anesthesia, there was posterior sagging and posterior drawer test was positive. Fixation done with cannulated cancellous screw 4.0mm (image intensifier guidance). The knee was immobilized at 20 degrees with a cylinder slab then changed to cylinder cast once swelling reduced. Cast was kept for 6 weeks followed by range of motion physiotherapy and progressive weight bearing. Full weight bearing, and range of motion achieved by 3 months post trauma without laxity or instability. Discussion: PCL avulsion is often missed in paediatric patients due to subtle or lack of Xray finding. In this case, mechanism of injury (knee in flexion falling forward with significant impact from behind) and the physical examination is typical of PCL injury lead to accurate decision for surgical intervention without waiting for the limited MRI availability. Furthermore, the placement of screw should be considered to avoid any damage to the plate. Conclusion: It is possible to diagnose PCL avulsion fracture from careful clinical and radiographical evaluation. Attending physician/surgeon must have high index of suspicion to identify this injury especially in young children
Dr Noorhuda Abdul Mutalif has completed her Medical Doctor (M.D.) degree from The National University of Malaysia 2013. She is currently working as Medical Officer in Orthopaedic Department, Melaka General Hospital, aspiring to be Orthopaedic Surgeon
E-mail: mshuda88@gmail.com