1. by George C. Balazs, Elizabeth M. Polfer, and Jefferson W. Jex
Bilateral Crush Injury of the Proximal Tibial Physis in an Adolescent Gymnast
by George C. Balazs, Elizabeth M. Polfer, and Jefferson W. Jex
JBJS Case Connect
Volume 5(2):e50
June 10, 2015
©2015 by The Journal of Bone and Joint Surgery, Inc.

2. Anteroposterior and lateral radiographs of both knees, demonstrating no apparent osseous abnormality.
Anteroposterior and lateral radiographs of both knees, demonstrating no apparent osseous abnormality. There is no evidence of physeal fracture on the radiographs.
George C. Balazs et al. JBJS Case Connect 2015;5:e50
©2015 by The Journal of Bone and Joint Surgery, Inc.

3. Coronal (left) and sagittal (right) T2-weighted MRI scans of the right knee, demonstrating periphyseal edema without a discrete fracture.
Coronal (left) and sagittal (right) T2-weighted MRI scans of the right knee, demonstrating periphyseal edema without a discrete fracture.
George C. Balazs et al. JBJS Case Connect 2015;5:e50
©2015 by The Journal of Bone and Joint Surgery, Inc.

4. Coronal (left) and sagittal (right) T2-weighted MRI scans of the left knee, demonstrating periphyseal edema without a discrete fracture.
Coronal (left) and sagittal (right) T2-weighted MRI scans of the left knee, demonstrating periphyseal edema without a discrete fracture.
George C. Balazs et al. JBJS Case Connect 2015;5:e50
©2015 by The Journal of Bone and Joint Surgery, Inc.

5. Anteroposterior and lateral radiographs of both knees, made at the time of the two-month follow-up, again demonstrating no apparent osseous fracture and no apparent growth abnormality or premature physeal closure.
Anteroposterior and lateral radiographs of both knees, made at the time of the two-month follow-up, again demonstrating no apparent osseous fracture and no apparent growth abnormality or premature physeal closure.
George C. Balazs et al. JBJS Case Connect 2015;5:e50
©2015 by The Journal of Bone and Joint Surgery, Inc.

6. Anteroposterior radiograph of both knees, made at the time of the ten-month follow-up, concerning for premature closure of the proximal tibial physis bilaterally.
Anteroposterior radiograph of both knees, made at the time of the ten-month follow-up, concerning for premature closure of the proximal tibial physis bilaterally. Note the central irregularity of the physes compared with earlier radiographs (arrows).
George C. Balazs et al. JBJS Case Connect 2015;5:e50
©2015 by The Journal of Bone and Joint Surgery, Inc.

7. Left: Bilateral coronal CT scan, showing an apparent physeal bar (arrow) constituting 25% of the right proximal tibial physis.
Left: Bilateral coronal CT scan, showing an apparent physeal bar (arrow) constituting 25% of the right proximal tibial physis. Right: Sagittal CT scan of the right knee, showing a bar (arrow) constituting 15% of the physis.
George C. Balazs et al. JBJS Case Connect 2015;5:e50
©2015 by The Journal of Bone and Joint Surgery, Inc.

8. Clinical photographs demonstrating the development of right knee recurvatum.
George C. Balazs et al. JBJS Case Connect 2015;5:e50
©2015 by The Journal of Bone and Joint Surgery, Inc.

9. Lateral radiographs, made with the knees in full extension, demonstrating right knee recurvatum deformity.
Lateral radiographs, made with the knees in full extension, demonstrating right knee recurvatum deformity.
George C. Balazs et al. JBJS Case Connect 2015;5:e50
©2015 by The Journal of Bone and Joint Surgery, Inc.