case_images: PMC8096571_01
case_images: Anteroposterior and lateral radiographs of the ankle fracture at time of presentation.
case_images: CRIOR2021-6646953.001.jpg
case_images: PMC8096571_01_CRIOR2021-6646953.001.jpg
case_images: fig1
case_images: Radiographs showed a displaced distal tibia SH type II physeal fracture and a transverse fracture of the fibula with valgus angulation (Figure 1).
case_images: Anteroposterior and lateral radiographs of the ankle following attempt of closed redcution.
case_images: CRIOR2021-6646953.002.jpg
case_images: PMC8096571_01_CRIOR2021-6646953.002.jpg
case_images: fig2
case_images: An initial attempt at closed reduction performed in the ED under conscious sedation was unsuccessful; the fracture could not be moved from its displaced position after sustained traction and manipulation (Figure 2).
case_images: Intraoperative photo showing interposition of tibialis posterior tendon (*) at the fracture site between the metaphysis and epiphysis.
case_images: CRIOR2021-6646953.003.jpg
case_images: PMC8096571_01_CRIOR2021-6646953.003.jpg
case_images: fig3
case_images: The tendon was bowstringing around the metaphyseal fragment from the proximal-posterior to distal-anterior direction between the metaphysis and epiphysis (Figure 3).
case_images: Mildly frayed tibialis posterior tendon (dashed arrow) repositioned and fracture reduction temporarily fixed by K-wire fixation.
case_images: CRIOR2021-6646953.004.jpg
case_images: PMC8096571_01_CRIOR2021-6646953.004.jpg
case_images: fig4
case_images: The tendon had mild fraying but did not show any laceration or tear (Figure 4).
case_images: Postoperative radiograph in the anteroposterior and lateral views with fixation by screws.
case_images: CRIOR2021-6646953.005.jpg
case_images: PMC8096571_01_CRIOR2021-6646953.005.jpg
case_images: fig5
case_images: The fracture reduction was confirmed on fluoroscopic evaluation, and two 4 mm partially threaded cannulated screws were used for fracture compression and fixation across the large Thurston-Holland metaphyseal fragment (Figure 5).
case_images: Anteroposterior and lateral radiographs of the ankle at 18-month follow-up.
case_images: CRIOR2021-6646953.006.jpg
case_images: PMC8096571_01_CRIOR2021-6646953.006.jpg
case_images: fig6
case_images: The radiographs showed complete healing of the fracture with no deformity and closing physis (Figure 6).