Introduction: Physeal injuries of proximal tibia are uncommon and constitute only 1% of all physeal injuries. Major vessel injuries are also rare in children and occur in 0.6% trauma cases, out of which, injuries of popliteal artery comprise only 5%. The combination of these is an extremely rare injury pattern but is potentially limb threatening. Most of the cases of physeal injuries of proximal tibia along with popliteal artery compromise, reported in the literature include Salter Harris (SH) type II, III, and IV patterns (type II being most common) with pure type I being extremely rare. Case Report: We describe a rare posteriorly displaced pure SH I injury of proximal tibial physis with compromised vascularity of the limb. Immediate closed reduction and stabilization with Kirschner wires (K-wires) restored the vascularity of the limb and the patient went on to have a good functional recovery at the last follow-up of 1 year. Conclusion: Vascular injuries occurring in SH 1 proximal tibial physeal fractures are often overlooked or missed due to the relatively benign appearance of slip with no sharp fragments to injure major vessels. Close monitoring of neurovascular status and a low threshold for fixation, for example, with K-wires, are important to prevent limb threatening ischemia in these relatively simple appearing injuries. Keywords: Hyperextension injury, physeal injury, proximal tibia, Salter-Harris 1, vascular injury.
Introduction: Sideswipe injury is often described as a complex elbow injury occurring when the elbow rests on a side bar of the window of a vehicle and is then impacted by another vehicle travelling in the same or opposite direction. Side swipe injury to the leg is uncommon. Although the term side swipe is mostly used for elbow injuries, we came across a case of open comminuted fibular fracture of right leg resulting from side swipe while travelling in a tricycle. Case Presentation: A 27-year-old male presented to us after sustaining an injury to his right leg while he was travelling in a tricycle with his right leg protruding out. There was an open wound of size 20 cm x 10 cm on lateral aspect of the middle one-third of his right leg and x-rays revealed a comminuted fracture of mid shaft of fibula. He was managed with debridement, vacuum assisted closure (VAC) dressing, split thickness skin grafting and plaster immobilization. At one year follow-up, the patient had excellent function in the leg with no activity limitation and just a minor loss of power in eversion. Conclusion: Sideswipe injury of the leg is an infrequently reported entity and can occur if the leg is protruding out while riding in a tricycle (autorickshaw). Keywords: Leg, Sideswipe injury, Tricycle related injury.
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