Growth plate injury is a debilitating condition for children. To our knowledge, there is currently no systematic review regarding the complication of epiphyseal injury. Thus, the authors would like to conduct a systematic review regarding this topic. The following strategy was used: the terms used on the PubMed search engine were “growth plate injuries complications.” Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used to perform the comprehensive data collection. The initial PubMed search yielded 341 titles and 81 articles included according to the inclusion criteria, but 20 articles were eliminated according to the exclusion criteria. The final total number of articles was 61. The epiphyseal injury usually ends with a good functional outcome, although some serious complication risk remains.

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BACKGROUND: Ten percent of all tuberculosis patients may develop skeletal involvement, and the spine is the most common anatomical location. Tuberculous spondylitis is further complicated by the fast-acid bacilli resistance to the usual chemotherapy regimen (multidrug-resistant/MDR) and its complications. In this case series, we would like to present three MDR tuberculous spondylitis cases effectively treated with tailored chemotherapy regimens and surgical interventions. CASE REPORT: A series of three patients with MDR tuberculous spondylitis is presented. All three patients presented with back pain, lump, and weakness of both lower extremities. These cases were resolved with a combination of surgical intervention and tailored chemotherapy regiment after MDR resistant detected. Two cases were resolved completely, and only one patient had residual paresthesia on his legs. CONCLUSION: A combination of MDR antituberculous chemotherapy and surgical intervention leads to an excellent outcome, in which the patient can perform regular daily tasks without pain, even in complicated MDR tuberculous spondylitis cases.

BACKGROUND: Regardless of the type of intra-articular anterior cruciate ligament (ACL) reconstruction performed, a certain degree of rotatory instability is often seen after surgery. Recent studies suggest that the anterolateral ligament (ALL) plays a significant role in maintaining stability during internal rotation of the tibia at high knee flexion angles. Unrecognized damage to the ALL may potentially be associated with a positive pivot shift despite a surgically reconstructed ACL being done. AIM: The primary objective of this study was to determine whether a concomitant ALL tear is associated with a high-grade pivot shift before and after ACL reconstruction. METHODS: This study was a retrospective cohort study of patients that underwent single-bundle ACL reconstruction surgery in our institution from October 2014 to March 2017. One hundred and forty-four patients were included in this study. All data were extracted from the department of ACL registry. All knee MRIs were reviewed by the author and coauthor to determine the integrity of the ALL. Subjects were divided into two groups based on the grade of pivot shift before surgery. The prevalence of ALL tear based on MRI was further compared between high-grade and low-grade pivot-shift groups. RESULTS: Overall, the prevalence of a concomitant ALL tear was 70.83%. Comparing the prevalence of concomitant ALL tear between the high-grade pivot-shift group (73.11%) and low-grade pivot-shift group (60%), we had insufficient evidence to demonstrate an association between pre-surgery high-grade pivot shift and concomitant ALL tear. After surgery, none of the patients had a high-grade pivot shift or was positive for Lachman’s test. CONCLUSION: There is a high prevalence of concomitant ALL tear in patients with torn ACL. We have insufficient evidence to demonstrate an association between the presence of a torn ALL and high-grade pivot shift before and after single-bundle ACL reconstruction.

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