
Muhammad Mubashir Siddiqui
Manchester University NHS Foundation Trust, United KingdomTitle: Pathological distal tibial and fibular fracture: A case report” and “Departmental teaching audit – Increasing non-core teaching hours for foundation doctors
Abstract
Introduction: Paediatric tibial fractures represent 15% of all
paediatric fractures and are the third most common paediatric long bone
fracture after the femur and radius-ulna. Of these, approximately 30% are
associated with a fibular fracture. Management options for these fractures
includes conservative and surgical treatment.
Aim: The aim of this case report was to review and present the
management and clinical outcome of a 10-year-old patient who sustained a
pathological fracture with a non-ossifying fibroma.
Method: A retrospective review of the clinical and radiological
case notes of the patient was carried out.
Report: This case reports a young patient who sustained a fracture
of the left distal tibia and fibula with an unusual lesion seen at the distal
tibial fracture site. This lesion was curetted out during surgery and filled
with an injectable synthetic bone void filler. Histological report of the
lesion showed no evidence of malignancy. The patient was regularly followed up
in clinic where he had a specialised regimen for foot support and
weightbearing. X-Ray’s done 18-months post-operatively showed full healing of
the fracture and complete consolidation of the cyst.
Conclusion: Pathological fractures can often be the initial
presentation of a bone lesion which are often asymptomatic and picked up
incidentally on X-rays. The presence of a bone lesion complicates fracture
management. It is essential bone samples are sent from surgery to histology for
a report to aid with the diagnosis. This guides treatment and long-term
management and aids towards incidence and prevalence data for the disease.